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

charlatan

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Individuals with large followings can influence public opinions and behaviors, especially during a pandemic. In the early days of the COVID pandemic, US president Donald J Trump endorsed the use of unproven therapies. Subsequently, a death attributed to the wrongful ingestion of a chloroquine-containing compound occurred.

This paper investigated Donald J Trump’s speeches and Twitter posts, as well as Google searches and Amazon purchases, and television airtime for mentions of hydroxychloroquine, chloroquine, azithromycin, and remdesivir. Twitter sourcing was catalogued with Factba.se, and analytics data, both past and present, were analyzed with Tweet Binder to assess average analytics data on key metrics. Donald J Trump’s time spent discussing unverified treatments on the United States’ 5 largest TV stations was catalogued with the Global Database of Events, Language, and Tone, and his speech transcripts were obtained from White House briefings. Google searches and shopping trends were analyzed with Google Trends. Amazon purchases were assessed using Helium 10 software.

From March 1 to April 30, 2020, Donald J Trump made 11 tweets about unproven therapies and mentioned these therapies 65 times in White House briefings, especially touting hydroxychloroquine and chloroquine. These tweets had an impression reach of 300% above Donald J Trump’s average. Following these tweets, at least 2% of airtime on conservative networks for treatment modalities like azithromycin and continuous mentions of such treatments were observed on stations like Fox News. Google searches and purchases increased following his first press conference on March 19, 2020, and increased again following his tweets on March 21, 2020. The same is true for medications on Amazon, with purchases for medicine substitutes, such as hydroxychloroquine, increasing by 200%.

The authors concluded that individuals in positions of power can sway public purchasing, resulting in undesired effects when the individuals’ claims are unverified. Public health officials must work to dissuade the use of unproven treatments for COVID-19.

Trump is by no means the only politician who misled the public in matters of healthcare through ignorance, or stupidity, or both. Other recent examples that we previously discussed include, for instance:

Yes, Trump is not the only, but he is the most influential and might well be the most ignorant one:

For this reason alone – and there are many more – I hope he will not soon become merely a dark and scary chapter in the history of the US.

Manfred Lucha has been Baden-Württemberg’s Minister for Social Affairs, Health and Integration since 12 May 2016. He also is a staunch defender of homeopathy.

Lucha has repeatedly spoken out in favour of maintaining the reimbursement of costs for homeopathy by health insurance companies. He described anthroposophy and homeopathy as the essence of the Green Party. In August 2022, Lucha positioned himself against the Baden-Württemberg Medical Association on the subject of homeopathy. The Association had announced that additional training for doctors in homeopathy would be removed from the medical training catalogue. Health Minister Lucha stated that he still believed in the effectiveness of homeopathy and announced a legal review of the decision, as the Ministry of Health has legal supervision over the Medical Association. Lucha also criticised the plan by Federal Health Minister Karl Lauterbach to no longer allow homeopathic treatments to be paid for by health insurance companies. Finally, it seems safe to assume that Lucha is not amused about the new development about which I reported yesterday.

With so much outspoken engagement in the medical field, one would expect that Lucha has a solid background in evidence-based medicine and science. Yet, one would be mistaken.

After an apprenticeship as a chemical worker, Lucha completed secondary school and trained as a nurse at the Weißenau Psychiatric State Hospital. He went on to gain his university entrance qualification and studied social work. In 2005, he also completed a Master’s degree in ‘Management in Social and Health Care’. He then became the technical director of a community psychiatric centre in Friedrichshafen. Lucha is spokesman for the Bodensee district community psychiatric association and deputy federal chairman of the Federal Working Group of Community Psychiatric Associations.

Any education in evidence-based medicine?

No!

So, why does he feel he knows better than the experts?

I am not sure.

 

PS

Mr. Lucha, if you read these lines, please tell us.

To show my appreciation, I would then send you a copy of the German translation of my book on homeopathy.

The German medical profession is struggling to decide what stance it should take on homeopathy. The evidence is clear: homeopathy is a pure placebo therapy. But there are powerful lobby groups trying to prevent the general acceptance of this conclusion. Now, a further step towards progress has been taken.

After two years of heated debate, the Baden-Württemberg Medical Association, Germany, has decided that further training for doctors in homeopathy will be cancelled. In July 2022, the Assembly of Representatives had already voted in favour of removing homeopathy from the further training regulations in Baden-Württemberg. This move prompted fierce opposition on several levels; the Social Affairs Minister Manfred Lucha (Greens), for instance, called it the ‘absolutely the wrong signal’. Homeopathy is an important part of healthcare for many people, he had claimed.

The treatment of patients in Baden-Württemberg with homeopathy will neither be restricted nor prohibited by this step. Doctors who have already completed the further training programme or are still in the process of doing so will not be affected by the change.

The chamber’s evaluation had concluded that there is no scientific evidence showing that homeopathy is effective for any condition. The German Medical Association had arrived at the same verdict and, already in 2022, it had spoken out in favour of the abolition in 2022.

On this blog, we have regularly discussed the German homeopathy debate and its many twists and turns, e.g.:

I am fairly confident that, in the end, the evidence will prevail, the confusion will disappear, and an agreement with broad support will emerge also in Germany:

THE PLACE FOR HOMEOPATHY IS IN THE MEDICAL HISTORY BOOKS! 

 

 

 

Whooping cough is on the rise in many parts of the world; and it’s far from harmless. It has been reported that 9 infants died from whooping cough in England between November last year and the end of May 2024. Altogether a total of 7599 cases of whooping cough have been confirmed in England this year, with cases continuing to rise from 555 in January to 920 in February.

In France too, cases of whooping cough are rising among all ages, the French health authority has warned, saying vulnerable groups should check their vaccinations are up to date. Cases of the illness – called coqueluche in French – have been rising since the start of 2024, states Santé publique France (SPF). It has called for people to be vigilant.

I have recently argued that this might be not least due to the irresponsible advice of homeopaths. But homeopaths are by no means alone in this.

According to advice from MOTHER EARTH LIVING several natural home remedies help alleviate whooping cough symptoms (as well as cold and flu symptoms) and clear the pertussis infection. A teaspoon of fresh garlic juice taken 2 to 3 times a day is a potent, effective treatment.

A pinch of the Indian curry spice turmeric, taken at least twice a day, relieves whooping cough symptoms and helps clear the bacterial infection. (Odorless garlic and turmeric capsules may not be as effective as fresh ingredients, whose odors can be minimized by chewing fresh mint).

Ginger has antiviral, antibacterial, antiparasitic, antifungal, anti-inflammatory and expectorant properties. It boosts the immune system, warms and induces sweating (which helps push fever and toxins out of the body), and calms coughs and sore throats quickly. It also stimulates appetite, which is important to sick individuals weakened by infection.

____________________

There are numerous further SCAM-sites that give advice to use this or that SCAM. The recommended treatments all have one thing in common: they do not work to prevent or treat whooping cough.

If one member of your family has caught the infection, please do me a favour:

avoid SCAM and see a real doctor.

 

Recently, I heard JD Vance (the would-be Vicepresident of the US) proclaim: THE ENEMY ARE THE PROFESSORS! Unsurprisingly, this remark alarmed me; I had not been previously aware of being an enemy of the people.

Vance stressed that this was a quote by Richard Nixon made some 40/50 years ago. I looked up Nixon’s quote and found that the original is apparently a little different:

Never forget, the press is the enemy. The establishment is the enemy. The professors are the enemy. The professors are the enemy. Write that on a blackboard a hundred times and never forget it.

So, why does Vance quote Nixon (arguably not one of the most honest men in the history of US politics) and insist on THE PROFESSORS ARE THE ENEMY? Why was this puzzling quote followed by plenty of applause from his audience?

The answer must be that it is a populist theme that touches a nerve with right-wing voters. But what does the sentence actually mean?

On Vance’s campaign website, he explains that “hundreds of billions of American tax dollars” get sent to universities that “teach that America is an evil, racist nation.” These universities “then train teachers who bring that indoctrination into our elementary and high schools.” Vance doesn’t want public funds to go to institutions that teach “critical race theory or radical gender ideology.” He rather wants them to deliver “an honest, patriotic account of American history.”

Vance and Nixon are not the first politicians to recently claimed that the enemies are the professors. In 2016, the UK conservative Michael Gove refused to name any economist backing Britain’s exit from the European Union, saying that “people in this country have had enough of experts”.

According to Wikipedia, anti-intellectualism is hostility to and mistrust of intellectintellectuals,  and intellectualism, commonly expressed as deprecation of education and philosophy and the dismissal of artliteraturehistory, and science as impractical, politically motivated, and even contemptible human pursuits. Anti-intellectuals may present themselves and be perceived as champions of common folk—populists against political and academic elitism—and tend to see educated people as a status class that dominates political discourse and higher education while being detached from the concerns of ordinary people. Totalitarian governments have, in the past, manipulated and applied anti-intellectualism to repress political dissent. During the Spanish Civil War (1936–1939) and the following dictatorship (1939–1975) of General Francisco Franco,  the reactionary repression of the White Terror (1936–1945) was notably anti-intellectual, with most of the 200,000 civilians killed being the Spanish intelligentsia, the politically active teachers and academics, artists and writers of the deposed Second Spanish Republic (1931–1939). During the Cambodian Genocide (1975–1979), the totalitarian regime of Cambodia led by Pol Pot nearly destroyed its entire educated population.

Fascist movements are notoriously anti-intellectual and anti-science. Adolf Hitler said he regretted that his regime still had some need for its “intellectual classes,” otherwise, “one day we could, I don’t know, exterminate them or something.” And Joseph Goebbels said this: “There was no point in seeking to convert the intellectuals. For intellectuals would never be converted and would anyway always yield to the stronger, and this will always be the man in the street. Arguments must therefore be crude, clear and forcible, and appeal to emotions and instincts, not the intellect. Truth was unimportant and entirely subordinate to tactics and psychology.” And the ‘bon mot’, “when I hear the word culture, I reach for my gun”, is attributed even to several of the top Nazis of the Third Reich.

And here we might have a reason why a certain type of politician dislikes intellectuals and feels that the enemy are the professors. Professors do science, science is about truth, and the truth is something that politiciance like Vance must fear like the pest. It would disclose their agenda as being fascist.

In conclusion, the claim, “THE PROFESSORS ARE THE ENEMY”, is an argument of polititians who have good reason to fear the truth, and it appeals to voters who are too dim to understand the danger posed by those they wish to elect.

 

 

 

 

Several years ago, I reported on the range of conditions which, according to homeopaths, “respond best to homeopathic treatment” (basically any condition imaginable). To remind you, here is the list again:

ENT and bronchial problems

  • Ear infections,
  • rhinitis,
  • sinusitis,
  • pharyngitis,
  • tonsillitis,
  • tracheitis,
  • bronchitis,
  • asthma.

Digestive problems

  • Stomach complaints
  • acidity,
  • heartburn,
  • fullness,
  • poor digestion,
  • flatulence,
  • duodenal ulcer,
  • diarrhoea,
  • constipation,
  • nausea,
  • vomiting,
  • canker sores.

Cardiovascular problems

Osteoarticular complaints

All types of muscle and/or joint pain due to arthrosis or arthritis:

  • neck pain,
  • shoulder pain,
  • elbow pain,
  • wrist pain,
  • Back pain,
  • sciatica,
  • knee pain,
  • ankle pain,
  • Sprains,
  • contractures etc.

Traumas

Urological disorders

Gynaecological problems

Dermatological problems

  • Eczema, hives,
  • Acne vulgaris, acne rosacea,
  • Recurrent boils, verucas, plantar warts,
  • Molluscum contagiosum,
  • Herpes simple and zoster
  • Psoriasis

Neurological disorders

  • Headaches and migraines.
  • Eye problems
  • Conjunctivitis,
  • blepharitis,
  • styes, dacryocistitis,
  • uveitis.

Behavioural and psychiatric disorders

  • Anxiety,
  • depression,
  • stress,
  • mental fatigue,
  • Pediatric problems,
  • Ear infections,
  • tonsillitis,
  • bronchitis,
  • asthma,
  • diarrhoea,
  • vomiting,
  • skin complaints,
  • canker sores,
  • teething problems,
  • sleep disorders,
  • educational attainment issues,
  • behavioural issues.

Endocrine disorders

  • Obesity,
  • hypothyroidism,
  • hyperthyroidism,
  • Depleted immune defences,
  • Recurrent infections affecting the throat,
  • sinuses, nose, ears,
  • connective tissue, larynx,
  • bronchial tubes,
  • lungs,
  • skin,
  • bladder etc.

Palliative care

For the treatment of the diverse symptoms that appear over the course of the illness. Homeopathy can improve the patient’s general wellbeing and counteract the side effects of other treatments.

These are just a few examples, but the list could be endless – it is important to stress that homeopathy is very effective in pathologies that are difficult to establish or those with contradictory or paradoxical symptoms.

In recurrent illnesses, homeopathic medicines can boost the defences and help to regulate the sufferer’s body in order to prevent further relapses.

Homeopathy is an excellent preventive medicine.

_______________________

You will notice that SCIATICA is on the list.

Would they really be as daft as to use homeopathy for sciatica?

Not only that, they would even conduct a study on the subject. Here is this recently published trial:

Objectives: Sciatica is a debilitating condition that causes pain in its distribution or in the lumbosacral nerve root that is connected to it. Although there are claims that homeopathy can reduce sciatica pain, systematic scientific proof is currently lacking. The objective of the trial was to determine whether individualized homeopathic medicines (IHMs) were as effective as identical-looking placebos in treating sciatica pain. Design: This is a double-blind, randomized (1:1), two parallel arms, placebo-controlled trial. Setting: The study was conducted at Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, West Bengal, India. Subjects: Sixty participants with sciatica pain were included in this study. Interventions: Verum (n = 30; IHMs plus concomitant care) versus control (n = 30; placebos plus concomitant care). Outcome measures: Primary-Sciatica Bothersome Index (SBI) and Sciatica Frequency Index (SFI) scores and secondary-Roland Morris Pain and Disability Questionnaire (RMPDQ), Short Form McGill Pain Questionnaire (SF-MPQ), and Oswestry Low Back Pain Questionnaire (OLBPQ) scores: all of them were measured at baseline, and every month, up to 3 months. Results: Intention-to-treat sample (n = 60) was analyzed. Group differences were examined by two-way (split-half) repeated measure analysis of variance, primarily accounting for between groups and time interactions, and additionally, by unpaired t tests comparing the estimates obtained individually every month. The level of significance was set at p < 0.025 and <0.05 two tailed for the primary and secondary outcomes, respectively. Group differences could not achieve significance in SBI (p = 0.044), SFI (p = 0.080), and RMPDQ scores (p = 0.134), but were significant for SF-MPQ (p = 0.007) and OLBPQ (p = 0.036). Gnaphalium polycephalum (n = 6; 10%) was the most frequently prescribed medicine. No harm, serious adverse events, or intercurrent illnesses were recorded in either of the groups. Conclusions: The primary outcome failed to demonstrate evidently that homeopathy was effective beyond placebo, and the trial remained inconclusive. Independent replications are warranted to confirm the findings.

So, homeopathy does not work for sciatica.

Surprise, surprise!

Why not?

Simple: because homeopathy does not work for any condition.

Project 2025 is a set of proposals from the US Heritage Foundation to reform the US according to right-wing ideology and to consolidate executive power shouldTrump win the 2024 presidential election. The project is a most frightening blueprint for fascism in the US and would have serious implications for the rest of the world. It would also profoundly impact on healthcare (my expertise) in multiple ways.

Here are some of them:

According to Project 2025, the federal government should prohibit Medicare from negotiating drug prices and promote the Medicare Advantage program, which consists of private insurance plans. Federal healthcare providers should deny gender-affirming care to transgender people and eliminate insurance coverage of the morning-after-pill Ella. Project 2025 also suggests a number of ways to cut funding for Medicaid, such as caps on federal funding, limits on lifetime benefits per capita, and letting state governments impose stricter work requirements for beneficiaries of this program. Other proposals include limiting state use of provider taxes, eliminating preexisting federal beneficiary protections and requirements, increasing eligibility determinations and asset test determinations to make it harder to enroll in, apply for and renew Medicaid, providing an option to turn Medicaid into a voucher program, and eliminating federal oversight of state medicaid programs.

Project 2025 insists that life begins at conception. The Mandate says that the Department of Health and Human Services (HHS) should “return to being known as the Department of Life”. Project 2025 says it would reposition department policies “by explicitly rejecting the notion that abortion is health care and by restoring its mission statement under to include furthering the health and well-being of all Americans ‘from conception to natural death’.”

The project opposes any initiatives that, in its view, subsidize single parenthood. Project 2025 encourages the next administration to rescind some of the provisions of the Family Planning Services and Population Research Act of 1970, which offers reproductive healthcare services, and to require participating clinics to emphasize the importance of marriage to potential parents.

According to Project 2025, the Food and Drug Administration is “ethically and legally obliged to revisit and withdraw its initial approval” of the abortion pills mifepristone and misoprostol. It recommends that the Centers for Disease Control and Prevention “update its public messaging about the unsurpassed effectiveness of modern fertility awareness-based methods” of contraception, such as smartphone applications that track a woman’s menstrual cycle. The project also seeks to restore Trump-era “religious and moral exemptions” to contraceptive requirements under the Affordable Care Act, including emergency contraception, which it deems an abortifacient, to defund Planned Parenthood, and to remove protection of medical records involving abortions from criminal investigations if the owners of said records cross state lines.

Project 2025 aims to prohibit sending abortion pills and medical equipment used for abortions through the mail; the plan would allow criminal prosecution for senders and receivers of abortion pills. Project 2025 does not explicitly promote the prohibition of abortion, but some legal experts and abortion rights advocates said adopting the Project’s plan would cut off access to medical equipment used in surgical abortions to create a de facto national abortion ban.

Project 2025 advises the federal government to deprecate what it considers promotion of abortion and high-risk sexual behaviors among adolescents. It also seeks to remove the role of the Department of Health and Human Services in shaping sex education in the United States, arguing that this is tantamount to creating a monopoly.

__________________________

If you think this part on healthcare (within my area of expertise) is crazy or dangerous, you should see the rest of the document (not my area of expertise)!

Donald Trump tried hard to deny that he has anything to do with the project. But this as been largely in vain. However, the Democratic National Committee is rolling out a media blitz connecting him to it. This campaign will erect splashy billboards in major cities throughout the battleground states including Atlanta, Las Vegas, Raleigh, Charlotte, Philadelphia, Detroit, Lansing, Grand Rapids, Green Bay, and Phoenix.

Project 2025 is being staffed with countless members of Trump’s administration as well as close advisers. “I know nothing about Project 2025. I have not seen it, have no idea who is in charge of it, and, unlike our very well received Republican Platform, had nothing to do with it,” “Trump’s Plan to be a dictator day one: Project 2025. Google it,” reads one billboard. Another explains how Project 2025 will eviscerate our checks and balances, enable a Trump revenge tour, and ban abortion nationally. It is, in the truest sense, a blueprint for a fascist America.

To accuse anyone of an abuse of science is a hefty charge, I know. In the case of proponents of so-called alternative medicine (SCAM) doing science, it is, however, often justified. Let me explain this by using the example of chiropractors (I could have chosen homeopathy, faith heaalers, acupuncturists or almost any other type of SCAM professional, but in recent times it was the chiros who provided the clearest examples of abuse).

Science can be seen as a set of tools that is used to estabish the truth. In therapeutics, science is employed foremost to answer three questions:

  1. Is the therapy plausible?
  2. Is the therapy effective?
  3. Is the therapy safe?

The way to answer them is to falsify the underlying hypotheses, i.e. to demonstrate that:

  1. The therapy is not plausible.
  2. The therapy is not effective.
  3. The therapy is not safe.

Only if rigorous attempts at falsifying these hypotheses have falied can we conclude that:

  1. The therapy is plausible.
  2. The therapy is effective.
  3. The therapy is safe.

I know, this is rather elementary stuff. It is taught during the first lessons of any decent science course. Yet, proponents of SCAM are either not being properly taught or they are immune to even the most basic facts about science. On this blog, we regularly have the opportunity to observe exactly that when we read and are bewildered by the comments made by SCAM proponents. This is often clearest in the case of chiropractors.

  1. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is plausible.
  2. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is effective.
  3. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is safe.

If they conduct research, they set up their investigations in such a way that they confirm their beliefs:

  1. Spinal manipulations are plausible.
  2. Spinal manipulations are effective.
  3. Spinal manipulations are safe.

In other words, they do not try to falsify hypotheses, but they do their very best to confirm them. And this, I am afraid, is nothing other than an abuse of science.

QED

And how can the average consumer (who may not always be in a position to realize whether a study is reliable or not) tell when such abuse of science is occurring? How can he or she decide who to trust and who not?

A simplest but sadly not fool-proof advice might consist in 2 main points:

  1. Never rely on a single study.
  2. Check whether there is a discrepancy in the results and views of SCAM proponents and independent experts; e.g.:
    • Chiropractors claim one thing, while independent scientists disagree or are unconvinced.
    • Homeopath claim one thing, while independent scientists disagree or are unconvinced.
    • Acupuncturists claim one thing, while independent scientists disagree or are unconvinced.
    • Energy healers claim one thing, while independent scientists disagree or are unconvinced.
    • Naturopaths claim one thing, while independent scientists disagree or are unconvinced.
    • Etc., etc.

In all of those cases, your alarm bells should ring and it might be wise to be cautious and avoid the treatment in question.

Yesterday, I stumbled across this remarkable notice. As it is in German, I took the libery of translating it for you:

Am 6. April 2024 war es wieder soweit: Die ÖGHM und die Schwabe Austria GmbH luden zur Verleihung des mit 4.000,- Euro dotierten Dr. Peithner Preises ein.

Dieses Mal wurde der Forschungspreis für die zwei eingereichte Arbeiten „Recommendations in the design and conduction of randomized controlled trials in human and veterinary homoeopathic medicine“ und „Recommendations for Designing, Conducting and Reporting Clinical Observational Studies in Homeopathic Veterinary Medicine“ an Katharina Gaertner, Klaus von Ammon, Philippa Fibert, Michael Frass, Martin Frei-Erb, Christien Klein-Laansma, Susanne Ulbrich-Zuerni und Petra Weiermayer vergeben.

Wir freuen uns sehr und gratulieren den Preisträger:innen zum verdienten Erfolg. Ein herzliches Dankeschön geht auch an die ÖGHM und die Schwabe Austria, die nicht nur mit diesem traditionellen Forschungspreis die Wissenschaft unterstützt.

Here is my translation:

On 6 April 2024, the time had come again: the ‘Austrian Society for Homeopathic Medicine’ (ÖGHM) and Schwabe Austria GmbH hosted the award ceremony for the Dr Peithner Prize, which is endowed with 4,000 euros.

This time, the research prize was awarded to Katharina Gaertner, Klaus von Ammon, Philippa Fibert, Michael Frass, Martin Frei-Erb, Christien Klein-Laansma, Susanne Ulbrich-Zuerni and Petra Weiermayer for the two submitted papers “Recommendations in the design and conduction of randomised controlled trials in human and veterinary homoeopathic medicine” and “Recommendations for Designing, Conducting and Reporting Clinical Observational Studies in Homeopathic Veterinary Medicine”.

We are delighted and congratulate the prizewinners on their well-deserved success. A big thank you also goes to the ÖGHM and Schwabe Austria, who support science with this traditional research prize.

______________________________

And where is the irony?

Firstly, homeopaths are not exactly the experts on how to conduct research.

Secondly, there are recommendations and guidelines for conducting clinical research (e.g. here), and there is no reason for homeopathy to not to adopt those.

Thirdly, and most importantly, to award a prize to Michael Frass for telling us how to do research is more than a little ironic. If anything, Frass could teach us a thing or two about how to falsify, fabricate and manipulate research results!

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