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

conspiracy

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I only now learned of the death of one of the most bizarre proponents that the cult of homeopathy has ever produced in its 200-year history. From his official obituary, one would not suspect much weirdness:

John R. Benneth obituary, 1952-2021, Portland, OR
John R. Benneth passed away Nov. 9, 2021 in Chico, Calif., after a long battle with Parkinson’s disease.

John shepherded the Pixieland Theatre in Lincoln City for many years, writing, directing, and acting in plays that kept audiences coming back. He appeared often on stage in Portland and became a familiar face in local and national commercials. In the mid-1980s he was the host, writer, and creative force behind The Portland Underground, a weekly, live, late-night local access show. He gave many local actors a chance to stretch their improv talents on that and his earlier show, Mysterious Planet. His was the voice of both Portland Talk Radio’s controversial Jack Hammer, and Kandu the Mystic. He later performed regularly as Mark Twain in Virginia City, Nev., and on cruises on Lake Tahoe. John started working as a private investigator in Portland in 1978, and in 1982, he founded the National Missing Children’s Locate Center, helping parents to find their children across the U.S. He later became internationally known for his research into and advocacy for Homeopathic Medicine and was invited to present a treatise on the subject at London’s Oxford University in 2010.
John was a member of both Hawthorne and Washington Masonic lodges and the Scottish Rite of Portland.
He was preceded in death by his parents, John and Bettiana Benneth; and by his wife, Catherine Benneth. He is survived by his brother, David; and his four sons, Horatio, Merlin, Cyrano and Evan.

The ‘Bolen report’ offers a little more, albeit weirdly unreliable information:

John Benneth, PG Hom.- London (Hons) is the renowned discoverer of the link between Homeopathy and Conventional Ionic Chemistry.

The first to accept a notorious challenge to Homeopathy, he forced the James Randi Educational Foundation (JREF), in 1999, to back down from a spurious offer to award $1,000,000 for a test identifying homeopathic solutes from their liquid aqueous vehicles.

In 2010, by invitation of Nobel laureate physicist Brian Josephson at Cambridge’s Cavendish Laboratory, he presented the Supramolecular Chemistry of the Homeopathic Remedy revealing structural changes and the physics of hydrolysis and molecular self assembling chain reactions.

He is the author of Ebola Prophylaxis and Cure detailing the use of FDA approved homeopathic pharmaceuticals in the treatment of hemorrhagic fevers, presented in advance of the reported successful use of homeopathic remedies to cure Ebola.

He is a proponent for the use of homeopathic pharmaceuticals to cure sepsis and other dire conditions for conventional use in hospital emergency and intensive care, and the Ionic Vaccine for the safe and effective non-molecular prevention of epidemic diseases.

To estimate the true extent of Benneth’s eccentricity, we need to read some of the posts by John himself johnbenneth.wordpress.com. Alternatively, we might access some of his appearances on youtube, quackometer, or even just a post I published several years ago.

I am sad that John is gone. I always thought he was mad like a hatter, but he had me in stitches whenever our paths crossed.

Almost 10 years ago, I posted this:

When I decided to become a doctor I, like most medical students, did so mainly to help suffering individuals. When I became a researcher, I felt more removed from this original ideal. Yet I told myself that, by conducting research, I might eventually contribute to a better health care of tomorrow. Helping suffering patients was still firmly on the agenda. But then I realised that my articles in peer-reviewed medical journals somehow missed an important target: in alternative medicine, one ought to speak not just to health care professionals but also to consumers and patients; after all, it is they who often make the therapeutic decisions in this area.

Once I had realised this, I started addressing the general public by writing for The Guardian and other newspapers, giving public lectures and publishing books for a lay audience, like TRICK OR TREATMENT…The more I did this sort of thing, the more I noticed how important this activity was. And when a friend offered to help me set up a blog, I did not hesitate for long.

So, the reason for my enthusiasm for this blog turns out to be the same as the one that enticed me to go into medicine in the first place. I do believe that it is helpful for consumers to know the truth about alternative medicine. Considering the thousands of sources of daily misinformation in this area, there is an urgent need for well-informed, critical information. By providing it, I am sure I can assist people to make better therapeutic decisions. In a way, I am back where I started all those years ago: hoping to help suffering patients in the most direct way my expertise allows.

Helping vulnerable patients often means warning them from dangerous charlatans, and this is precisely what I frequently try to do with this blog. But how successful are my endeavors?

More often than not, I have no idea and can only hope for the best. Sometimes I do get some feedback that is encouraging and motivates me to carry on. Rarely, however, do I witness immediate, tangible success. And this is why the recent story is so remarkable:

  • On 6 June, an Australian acquaintance from the FRIENDS OF SCIENCE IN MEDICINE sent me some material about a planned lecture in the UK by someone promoting dangerous quackery.
  • I looked into it and published a blog post about it a few hours later.
  • A reader then suggested in the comments section of this post alerting the UK press to it.
  • Another reader contacted THE TIMES, and I wrote to several other journalists.
  • THE TIMES turned out to be interested in the story.
  • They did some research and interviewed Michael Marshall from the GOOD THINKING SOCIETY (and myself).
  • Today, THE TIMES published an article about the planned event.
  • Finally, a kind person made the article available to those who don’t want to pay for it.

The whole thing amounts to superb teamwork, in my view. It shows how like-minded people who do not even all know each other can manage to achieve a respectable result with little more than goodwill and dedication.

A respectable result?

Of course, the optimal result would be to stop Barbara O’Neill’s UK lectures. Let’s hope this is what eventually will happen – and please let me know if you know more.

This article almost left me speechless:

The back-to-back waves of the COVID-19 pandemic have made a devastating impact globally. The conventional healthcare system is going through serious pressure as cases of the disease continue to spread and the numbers of hospitalizations are increasing every moment. It is becoming hard and challenging because the hospital resources are limited in number as compared with the rate of daily hospitalizations. There are significant shortages of patient care facilities and medical care providers, and on top of that, conventional healthcare systems do not have any proven treatments for COVID-19 patients. Experimental drugs like hydroxychloroquine, followed by remdesivir, ritonavir/lopinavir, and favipiravir are being administered under emergency use authorization (EUA). There is evidence that these experimental medications are causing adverse drug reactions, thus claiming the lives of the hospitalized COVID-19 patients. And those patients who survive the EUA medications and hospitalizations are left with iatrogenic immunosuppressive states leading to increased susceptibility towards secondary life-threatening infections like fungal diseases. In this scenario, complementary and alternative medical systems (CAMS) are providing commendable results with negligible adverse effects or iatrogenic issues in patients with COVID-19. There are several clinical cases recorded and published by various independent homoeopathic doctors and researchers worldwide. But unfortunately, because of a biased medical model and greed for monopolies, these effective treatment methods are not given equal opportunity as their conventional counterparts.

I think the best way to react to this nonsense might be to remind us what the only RCT of homeopathy for COVID showed.

This randomized, double-blind, two-armed, parallel, single-center, placebo-controlled study investigated the effectiveness and safety of the homeopathic medicine, Natrum muriaticum LM2, for mild cases of COVID-19.

Participants aged > 18 years, with influenza-like symptoms and a positive COVID test were recruited and randomized (1:1) into two groups that received different treatments during a period of at-home isolation. One group received the homeopathic medicine Natrum muriaticum, prepared with the second degree of the fifty-millesimal dynamization (LM2; Natrum muriaticum LM2), while the other group received a placebo.

The primary endpoint was time until recovery from COVID-19 influenza-like symptoms. Secondary measures included a survival analysis of the number and severity of COVID-19 symptoms (influenza-like symptoms plus anosmia and ageusia) from a symptom grading scale that was informed by the participant, hospital admissions, and adverse events. Kaplan-Meier curves were used to estimate time-to-event (survival) measures.

Data from 86 participants were analyzed (homeopathy, n = 42; placebo, n = 44). There was no difference in time to recovery between the two groups (homeopathy, n = 41; placebo, n = 41; P = 0.56), nor in a sub-group that had at least 5 moderate to severe influenza-like symptoms at the beginning of monitoring (homeopathy, n = 15; placebo, n = 17; P = 0.06). Secondary outcomes indicated that a 50% reduction in symptom score was achieved significantly earlier in the homeopathy group (homeopathy, n = 24; placebo, n = 25; P = 0.04), among the participants with a basal symptom score ≥ 5. Moreover, values of restricted mean survival time indicated that patients receiving homeopathy might have improved 0.9 days faster during the first five days of follow-up (P = 0.022). Hospitalization rates were 2.4% in the homeopathy group and 6.8% in the placebo group (P = 0.62). Participants reported 3 adverse events in the homeopathy group and 6 in the placebo group.

The authors concluded that the results showed that Natrum muriaticum LM2 was safe to use for COVID-19, but there was no statistically significant difference in the primary endpoints of Natrum muriaticum LM2 and placebo for mild COVID-19 cases. 

Another relevant study compared the antibody response of homeopathic and conventional vaccines and placebo in young adults. A placebo-controlled, double-blind RCT was conducted where 150 university students who had received childhood vaccinations were assigned to diphtheria, pertussis, tetanus, mumps, measles homeopathic vaccine, placebo, or conventional diphtheria, pertussis, tetanus (Tdap) and mumps, measles, rubella (MMR) vaccines. The primary outcome was a ≥ two-fold increase in antibodies from baseline following vaccination as measured by ELISA. Participants, investigators, study coordinators, data blood drawers, laboratory technicians, and data analysts were all blinded.

None of the participants in either the homeopathic vaccine or the placebo group showed a ≥ two-fold response to any of the antigens. In contrast, of those vaccinated with Tdap, 68% (33/48) had a ≥ two-fold response to diphtheria, 83% (40/48) to pertussis toxoid, 88% (42/48) to tetanus, and 35% (17/48) of those vaccinated with MMR had a response to measles or mumps antigens (p < 0.001 for each comparison of conventional vaccine to homeopathic vaccine or to placebo). There was a significant increase in geometric mean titres of antibody from baseline for conventional vaccine antigens (p < 0.001 for each), but none for the response to homeopathic antigens or placebo.

The authors concluded that homeopathic vaccines do not evoke antibody responses and produce a response that is similar to placebo. In contrast, conventional vaccines provide a robust antibody response in the majority of those vaccinated.

To give ‘equal opportunity’ to implausible therapies would, in my view, not merely be wrong, it would be scandalously unethical. The role of homeopathy in the prophylaxis and symptomatic management of COVID-19 or other infections is very easily described; it is:

zero,

nil,

nothing,

null,

naught,

zilch.

I have previously reported about the ‘Havelhöhe Community Hospital’ in Berlin and its medical director, Prof Harald Matthes. He made headlines two years ago when he claimed that anthroposophical remedies were effective for treating COVID. More recently, Matthes made headlines again when he went on TV claiming that serious adverse effects of COVID vaccinations were 40 times more frequent than generally accepted.

Now a German newspaper reports more about the ‘Havelhöhe Community Hospital’ and its medical director. Here are a few (translated) passages from this remarkable article:

At the Havelhöhe Community Hospital in Berlin, there are considerable shortcomings in the handling of the Corona pandemic … basic protective measures are in part neither adhered to nor monitored. In addition, employees of the anthroposophical clinic are recommended a vaccination regimen for which there is no approval, i.e. the option of “dose splitting with frequency increase,” in which the vaccine usually administered at one time is to be divided among several injections.

However, there is no official basis for this vaccination scheme. “There is no vaccine approved for it, and it does not correspond in any way to the Stiko recommendation,” said Gudrun Widders, the public health officer responsible. “My hair stands on end when I hear that,” says the head of the Berlin-Spandau health department, who is also a member of the Standing Commission on Vaccination.

Visitors of the hospital Havelhöhe can enter buildings and wards without control of the inoculation status or a daily updated test result which is against current regulations in Germany. While other Berlin hospitals such as the Charité imposed bans on visitors, a public concert took place at Havelhöhe Hospital, where the audience did not wear a mask, contrary to the valid Corona protection regulation. Employees of the hospital also report to the taz that many of the hospital staff are lax about wearing masks, even when on duty.

“I can only say something when I see someone,” said hospital director Harald Matthes. “And I don’t see anyone with me in the hospital who walks around without a mask.” Matthes had publicly criticized corona measures as excessive on several occasions.

________________________________

I have said it before and I say it again: in my view, Matthes’ behavior amounts to serious professional misconduct. I, therefore, suggest that his professional body, the Aerztekammer, look into it with a view of preventing further harm.

 

 

 

During the last two years, I have written more often than I care to remember about the numerous links between so-called alternative medicine (SCAM) and COVID-19 vaccination hesitancy. For instance:

Whenever I publish a post on these subjects, some enthusiasts of SCAM argue that, despite all this evidence, they are not really against COVID vaccinations. But who is correct? What proportions of SCAM practitioners are pro or contra? One way to find out is to check how they themselves behave. Do they get vaccinated or not?

Here are some recent data from Canada that seem to provide an answer.

A breakdown of vaccination rates among Canadian healthcare professions has been released, based on data gathered from 17 of B.C.’s 18 regulated colleges. The findings are most revealing:

  • dieticians, physicians, and surgeons lead the way, with vaccination rates of 98%,
  • occupational therapists were at 97%,
  • Chinese medicine practitioners and acupuncturists were at 79%,
  • chiropractors at 78%
  • naturopaths at 69%.

The provincial health officer Dr. Bonnie Henry said the province is still working with the colleges on how to notify patients about their practitioner’s vaccination status. “We are working with each college on how to build it into professional standards. The overriding principle is patient status,” she told a news conference. “It may be things like when you call to book, you are asked whether you would prefer to see a vaccinated or unvaccinated professional. We are trying to protect privacy and provide agency to make the decision.”

______________________

As far as I am aware, these are unique data. It would be interesting to see additional evidence. If anyone knows about vaccination rates in other countries of acupuncturists, herbalists, homeopaths, osteopaths, Heilpraktiker, etc. I would love to learn more.

Harad Matthes, the boss of the anthroposophical Krankenhaus Havelhoehe and professor for Integrative and Anthroposophical Medicine at the Charite in Berlin, has featured on my blog before (see here and here). Now he is making headlines again.

Die Zeit‘ reported that Matthes went on German TV to claim that the rate of severe adverse effects of COVID-19 vaccinations is about 40 times higher than the official figures indicate. In the MDR broadcast ‘Umschau’ Matthes said that his unpublished data show a rate of 0,8% of severe adverse effects. In an interview, he later confirmed this notion. Yet, the official figures in Germany indicate that the rate is 0,02%.

How can this be?

Die ZEIT ONLINE did some research and found that Matthes’ data are based on extremely shoddy science and mistakes. The Carite also distanced themselves from Matthes’ evaluation: “The investigation is an open survey and not really a scientific study. The data are not suitable for drawing definitive conclusions regarding incidence figures in the population that can be generalized” The problems with Matthes’ ‘study’ seem to be sevenfold:

  1. The data are not published and can thus not be scrutinized.
  2. Matthes’ definition of a severe adverse effect is not in keeping with the generally accepted definition.
  3. Matthes did not verify the adverse effects but relied on the information volunteered by people over the Internet.
  4. Matthes’ survey is based on an online questionnaire accessible to anyone. Thus it is wide open to selection bias.
  5. The sample size of the survey is around 10 000 which is far too small for generalizable conclusions.
  6. There is no control group which makes it impossible to differentiate a meaningful signal from mere background noise.
  7. The data contradict those from numerous other studies that were considerably more rigorous.

Despite these obvious flaws Matthes insisted in a conversation with ZEIT ONLINE that the German official incidence figures are incorrect. As Germany already has its fair share of anti-vaxxers, Matthes’ unfounded and irresponsible claims contribute significantly to the public sentiments against COVID vaccinations. They thus endangering public health.

In my view, such behavior amounts to serious professional misconduct. I, therefore, feel that his professional body, the Aerztekammer, should look into it and prevent further harm.

WARNING: SATIRE

This is going to be a very short post. Yet, I am sure you agree that my ‘golden rules’ encapsulate the collective wisdom of so-called alternative medicine (SCAM):

  1. Conventional treatments are dangerous
  2. Conventional doctors are ignorant
  3. Natural remedies are by definition good
  4. Ancient wisdom knows best
  5. SCAM tackles the roots of all health problems
  6. Experience trumps evidence
  7. People vote with their feet (SCAM’s popularity and patients’ satisfaction prove SCAM’s effectiveness)
  8. Science is barking up the wrong tree (what we need is a paradigm shift)
  9. Even Nobel laureates and other VIPs support SCAM
  10. Only SCAM practitioners care about the whole individual (mind, body, and soul)
  11. Science is not yet sufficiently advanced to understand how SCAM works (the mode of action has not been discovered)
  12. SCAM even works for animals (and thus cannot be a placebo)
  13. There is reliable evidence to support SCAM
  14. If a study of SCAM happens to yield a negative result, it is false-negative (e.g. because SCAM was not correctly applied)
  15. SCAM is patient-centered
  16. Conventional medicine is money-orientated
  17. The establishment is forced to suppress SCAM because otherwise, they would go out of business
  18. SCAM is reliable, constant, and unwavering (whereas conventional medicine changes its views all the time)
  19. SCAM does not need a monitoring system for adverse effects because it is inherently safe
  20. SCAM treatments are individualized (they treat the patient and not just a diagnostic label like conventional medicine)
  21. SCAM could save us all a lot of money
  22. There is no health problem that SCAM cannot cure
  23. Practitioners of conventional medicine have misunderstood the deeper reasons why people fall ill and should learn from SCAM

QED

I am sure that I have forgotten several important rules. If you can think of any, please post them in the comments section.

On this blog, I have almost exclusively written about so-called alternative medicine (SCAM), and I intend to continue along these lines. But today, I have to make an exception. The reason is the UK government’s ‘Rwanda Project’. I heard about it this morning while listening to the BBC, and I am too shocked to not write about it.

Already in 2020, it had been reported that the UK home secretary, Priti Patel, had asked officials to look into the possibility of sending all asylum seekers to Ascension, an isolated volcanic British island south of the Equator in the Atlantic Ocean.[1] At the time, the idea was met with much criticism and opposition. Today she is about to announce that a modification of her plan will, in fact, be implemented; our government is about to unveil plans to send ‘illegal migrants’ who reach Britain to Rwanda:

Flying asylum seekers to Rwanda to be processed is “despicable” and “evil”, critics have said as they hit out at government plans expected to be announced on Monday. ITV News has seen a government document that raises issues over the legality of such a policy, as ministers attempt to tackle small boat crossings of the Channel. The government document says the policy would carry the risk of legal challenges but is possible under current legislation should the government wish to push ahead. Boris Johnson is set to argue on Thursday that action is needed to combat the “vile people smugglers” turning the ocean into a “watery graveyard”. Many details of the expected announcement, such as whether it would apply just to those who arrived by what the government calls illegal means, remain unclear. The document seen by ITV News also states that any agreement of this nature would require the government to financially incentivise whichever country it reaches a deal with. Initial estimates had the policy costing in the tens of millions of pounds, but the document says this has been revised to the hundreds of millions of pounds.

The plan sounds utterly cynical, irrational, illegal, and expensive; and again there is an outrage; QC tweeted, for instance, this: “And if an asylum applicant who’s been dumped in Rwanda is then refused, what happens then? The whole thing is the stuff of nightmares. It feels like things are becoming increasingly dystopian as the days pass. Why oh why can’t we have some creative and humane people in charge.”

One might well ask, where does such an inhumane concept come from?

It turns out that it resembles an idea of the Third Reich that was equally baffling and similarly cruel.

Anticipating the German invasion of France in 1940, the German diplomat, Franz Rademacher, developed his Madagascar project, a bizarre plan to rid Europe of all Jews. It envisaged that:

  • once defeated, France would agree to make Madagascar available,
  • American Jewry would be blackmailed into funding the operation,
  • France would be forced to find an alternate home for the 25,000 French inhabitants of Madagascar.

The plan may now sound ridiculous but, in 1940, it was seriously considered by the Nazi leadership. In June of that year, Rademacher, who then was the head of the German Foreign Ministry’s Jewish Department, presented the idea to his boss, Joachim von Ribbentrop, who then explained it to Hitler. Hitler was sufficiently impressed to discuss it with Mussolini. Rademacher wrote that “The approaching victory gives Germany the possibility, and in my view also the duty, of solving the Jewish question in Europe. The desirable solution is: All Jews out of Europe.” [2] 

When Reinhard Heydrich, chief of the Reich Main Security Office, learned about the “Madagascar Project”, he highjacked it and swiftly put Adolf Eichmann in charge of it. On August 15, 1940, Eichmann published a pamphlet on the “Madagascar Project.” It envisaged that the deportation of the Jews would be carried out by the British merchant marine, after the anticipated invasion and defeat of the United Kingdom. Two ships per day would then leave Europe for Madagascar, each one carrying 1,500 Jews. In just a few years, Europe would thus become ‘Juden-frei’, free of Jews.

The Madagascar plan envisaged turning Madagascar into a monumental concentration camp under German control. The island is merely 228,900 square miles in size and would not have provided sufficient room for millions. It was therefore understood that many of the prisoners would perish, not least because of the lack of food, housing and healthcare as well as the difficult climate. 

Eventually, the Madagascar plan had to be abandoned. What was decided subsequently with Rademacher’s cooperation about the fate of the Jews, the ‘final solution’, was even more unspeakably outrageously abhorrent.

The main players involved in the Madagascar project did all perish:

  • Ribbentrop was sentenced to death at the Nuremberg trials.
  • Hitler committed suicide.
  • Heydrich was assassinated.
  • Eichmann was sentenced to death in Israel.

Only Rademacher survived. After the war, he was imprisoned by British military police who mistook him for ‘small fry’ and promptly released him. In 1952, he was put on trial in West Germany for the murders of Jews he had supervised in Serbia. Yet, aided by a network of Nazi sympathizers, he managed to flee to Syria. The German court then convicted him in his absence and sentenced him to 3 years and 5 months imprisonment. In 1962, an Israeli spy delivered a letter bomb to Rademacher in Syria who, however, remained unharmed. In 1966, Rademacher returned voluntarily to West Germany and was promptly re-arrested. This time, he was sentenced to five and half years, but never actually served a prison sentence. In 1971, the German high court overruled the former judgment and ordered a new trial to take place. However, Rademacher died on 17 March 1973, before it could take place.[3]

I hope that I am wrong and that the UK government’s plan is not similar to the Nazi’s “Madagascar Project”. Maybe it is just a PR stunt of our PM to distract from his very own lawbreaking, and the ‘Rwanda project’ will never be implemented. In any case, we should urgently remind everyone of George Santayana’s wise words: “Those who cannot remember the past are condemned to repeat it.”

 

 

[1] https://www.independent.co.uk/news/uk/politics/priti-patel-asylum-ascensi on-island-atlantic-immigration-process-centre-b703625.html

[2] https://www.haaretz.com/jewish/.premium-1940-eichmann-plans-to-deport-jews-to-madagascar-1.5424692

[3] https://en.wikipedia.org/wiki/Franz_Rademacher

The pandemic has shown how difficult it can be to pass laws stopping healthcare professionals from giving unsound medical advice has proved challenging. The right to freedom of speech regularly conflicts with the duty to protect the public. How can a government best sail between Scylla and Charybdis? JAMA has just published an interesting paper addressing these issues. Here is an excerpt from the article that might stimulate some discussion:

The government can take several actions, including:

  • Imposing sanctions on COVID-19–related practices by licensed professionals that flout substantive laws in connection with providing medical services, even if those medical services include speech. This includes physicians failing to comply with COVID-19–related public health laws applicable to medical offices and health facilities, such as mask wearing, social distancing, and restrictions on elective procedures.
  • Sanctioning recommendations by professionals that patients take illegal medications or controlled substances without following legally required procedures. The government can also sanction the marketing by others of prescription medications for unapproved indications. However, “off-label” prescribing by physicians (eg, for hydroxychloroquine or ivermectin) remains lawful as long as a medication is approved by the US Food and Drug Administration for any indication and no specific legal conditions on use are in effect.
  • Enforcing tort law actions (eg, malpractice, lack of informed consent) in cases of alleged patient injury that result from recommending a potentially dangerous treatment or failing to recommend a necessary treatment.
  • Imposing sanctions on individualized medical advice by unlicensed individuals or organizations if giving that advice constitutes the unlawful practice of medicine.

In addition, the government probably can:

  • Impose sanctions for false or misleading information offered to obtain a financial or personal benefit, particularly if giving the information constitutes fraud under applicable law. This would encompass physicians who knowingly spread false information to create celebrity or attract patients.
  • Threaten disciplinary action by licensing boards against health professionals whose speech to patients conveys incorrect science or substandard medicine.
  • Specify the information that may and may not be imparted by private organizations and professionals as part of specific clinical services paid for by government, such as special programs for COVID-19 testing or treatment.
  • Reject legal challenges to, and enforce through generally applicable contract or employment laws, any restrictions private health care organizations place on speech by affiliated health professionals, particularly in the absence of special laws conferring “conscience” protections. This would include medical staff membership and privileges, hospital or other employment agreements, and insurance network participation.
  • Enforce restrictions on speech adopted by private professional or self-regulatory organizations if the consequences for violations are limited to revoking organizational membership or accreditation.

However, the government probably cannot:

  • Compel or limit health professional speech not made in connection with patient care, even if the speech is false or misleading, regardless of its alleged effect on public trust in health professions.
  • Sanction speech to the general public rather than to patients, whether or not by health professionals, especially if conveyed with a disclaimer that the speech is “not intended as medical advice.”
  • Sanction speech by health professionals to patients conveying political views or skepticism of government policy.
  • Enforce restrictions involving information by public universities and public hospitals that legislatures, regulatory agencies, and professional licensing boards would not be constitutionally permitted to impose directly.
  • Adopt restrictions on information related to overall clinical services funded by large government health programs, such as Medicare and Medicaid.

_____________________________

The article was obviously written with MDs in mind and applies only to US law. As we have seen in previous posts and comments, the debate is, however, wider. We should, I think, also have it in relation to practitioners of so-called alternative medicine (SCAM) and medical ethics. Moreover, it should go beyond advice about COVID and be extended to any medical advice given by any type of healthcare practitioner.

I have to admit that I grew tired of endless discussions around COVID with people who deny the proven facts. Yes, there is much uncertainty – as would be expected in a situation that in many ways was unprecedented. But there are also important issues that are quite clear:
  • COVID vaccinations are not 100% harmless but they generate much more good than harm.
  • They are certainly far less dangerous than the disease.
  • COVID infections are not ‘just a flu’ but have serious consequences.

The last point was well-documented in a recent Lancet paper. Here is its abstract in full

Mortality statistics are fundamental to public health decision making. Mortality varies by time and location, and its measurement is affected by well known biases that have been exacerbated during the COVID-19 pandemic. This paper aims to estimate excess mortality from the COVID-19 pandemic in 191 countries and territories, and 252 subnational units for selected countries, from Jan 1, 2020, to Dec 31, 2021.

Methods

All-cause mortality reports were collected for 74 countries and territories and 266 subnational locations (including 31 locations in low-income and middle-income countries) that had reported either weekly or monthly deaths from all causes during the pandemic in 2020 and 2021, and for up to 11 year previously. In addition, we obtained excess mortality data for 12 states in India. Excess mortality over time was calculated as observed mortality, after excluding data from periods affected by late registration and anomalies such as heat waves, minus expected mortality. Six models were used to estimate expected mortality; final estimates of expected mortality were based on an ensemble of these models. Ensemble weights were based on root mean squared errors derived from an out-of-sample predictive validity test. As mortality records are incomplete worldwide, we built a statistical model that predicted the excess mortality rate for locations and periods where all-cause mortality data were not available. We used least absolute shrinkage and selection operator (LASSO) regression as a variable selection mechanism and selected 15 covariates, including both covariates pertaining to the COVID-19 pandemic, such as seroprevalence, and to background population health metrics, such as the Healthcare Access and Quality Index, with direction of effects on excess mortality concordant with a meta-analysis by the US Centers for Disease Control and Prevention. With the selected best model, we ran a prediction process using 100 draws for each covariate and 100 draws of estimated coefficients and residuals, estimated from the regressions run at the draw level using draw-level input data on both excess mortality and covariates. Mean values and 95% uncertainty intervals were then generated at national, regional, and global levels. Out-of-sample predictive validity testing was done on the basis of our final model specification.

Findings

Although reported COVID-19 deaths between Jan 1, 2020, and Dec 31, 2021, totalled 5·94 million worldwide, we estimate that 18·2 million (95% uncertainty interval 17·1–19·6) people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period. The global all-age rate of excess mortality due to the COVID-19 pandemic was 120·3 deaths (113·1–129·3) per 100 000 of the population, and excess mortality rate exceeded 300 deaths per 100 000 of the population in 21 countries. The number of excess deaths due to COVID-19 was largest in the regions of south Asia, north Africa and the Middle East, and eastern Europe. At the country level, the highest numbers of cumulative excess deaths due to COVID-19 were estimated in India (4·07 million [3·71–4·36]), the USA (1·13 million [1·08–1·18]), Russia (1·07 million [1·06–1·08]), Mexico (798 000 [741 000–867 000]), Brazil (792 000 [730 000–847 000]), Indonesia (736 000 [594 000–955 000]), and Pakistan (664 000 [498 000–847 000]). Among these countries, the excess mortality rate was highest in Russia (374·6 deaths [369·7–378·4] per 100 000) and Mexico (325·1 [301·6–353·3] per 100 000), and was similar in Brazil (186·9 [172·2–199·8] per 100 000) and the USA (179·3 [170·7–187·5] per 100 000).

Interpretation

The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone. Strengthening death registration systems around the world, long understood to be crucial to global public health strategy, is necessary for improved monitoring of this pandemic and future pandemics. In addition, further research is warranted to help distinguish the proportion of excess mortality that was directly caused by SARS-CoV-2 infection and the changes in causes of death as an indirect consequence of the pandemic.

I am posting this in the hope that the many proponents of so-called alternative medicine (SCAM) who deny proven facts about COVID might learn and stop falling victim to proctophasia.

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