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

fraud

Guest post by: Loretta Marron

In March 1991, the Australian College of Allergy published an article in the Medical Journal of Australia (MJA) about a ‘bioresonance’ device for allergy testing. Titled “VEGA testing in the diagnosis of allergic conditions”, it stated that it was “an unorthodox method of diagnosing allergic and other diseases” with “no established scientific basis” and “no controlled trials to support its usefulness”.

The article raised concerns that this test “may lead to inappropriate treatment and expense to the patient and community”. VEGA is one of nearly 30 ‘energy medicine’ devices, some of which continue to cite Therapeutic Goods Administration (TGA) ‘listing numbers’.

Sometime costing more than $34,000, the sponsors tell practitioners that they can earn up to $150,000 annually with these computerised devices. Referring to ‘bioresonance’ as “the medicine of the future”, they claim that all toxins, viruses and bacteria have unique ‘frequency patterns’, which, when ‘neutralised’ by the device, restore the patient to health. They may also claim that it can cure addictions to alcohol, cocaine, crack, nicotine, heroin, opiates, cannabis, spice, ‘legal highs’ and other medications. Some claim that it can cure cancer, hay fever, allergies, auto-immune diseases, behavioural problems, smoking addiction and that they can kill parasites – the list goes on.

The devices are ‘based’ on acupuncture, homeopathy and ‘quantum physics’. More than 60 reviews in the Cochrane Collaboration (the ‘Gold Standard’ for evidence-based Medicine), have failed to find robust evidence for clinically significant outcomes for acupuncture for any disease or disorders. The National Health & Medical Research Council concluded, “there are no health conditions for which there is reliable evidence that homeopathy is effective” and quantum physics “is not at work”. In February 2020, nearly 30 years after that MJA article, the TGA’s cancellation of two of these devices saw the last of them removed from their register, but not from permissible advertising or practice.

From 2014 to 2018, Friends of Science in Medicine (FSM) had repeatedly written letters and submissions to the TGA asking for these devices to be investigated. Meeting with the national manager in 2016, we were told that these devices could not be cancelled because they were ‘biofeedback’ devices, which had a legitimate place in health care. In 2018, FSM sourced comments from informed experts here and overseas. These disputed the ‘biofeedback’ claim. FSM sent screenshots from more than 200 websites to the TGA advertising complaints. In 2019, after issuing a warning on bioresonance, the TGA closed the complaints and commenced an ‘education campaign’. They also engaged a credible Australian scientific organisation to review the evidence provided by eight ‘sponsors’ of 12 bioresonance’ devices listed in the Australian Register of Therapeutic Goods).

All devices have now been cancelled by their sponsors or by the TGA. The ‘education campaign’ continues. Even though the devices are still widely used, and courses still being run, FSM considers this a modestly satisfactory outcome.

Informed opinions:

Biofeedback:

o Michelle G Aniftos BCN, FCCLP, QEEGD, MEd, MPsych (Clinical), GradCertClinNeurophysiology, Fellow, Biofeedback Certification International Alliance, &

o Dr Tania M. Slawecki, PhD. Energy and the Environment Laboratory (formerly Materials Research Lab), Penn State University, USA (Author of “How to Distinguish Legitimate Biofeedback/Neurofeedback Devices”;

Electronic devices:

o Dr Stephen J Roberts, BSc ARCS DIC PhD. Consultant on electronic devices;

Psychology:

o Emeritus Professor Joseph P Forgas, AM, DPhil, Dsc (Oxford), FASSA, Scientia Professor, Psychology, UNSW &

Alternative medicine:

o Emeritus Professor Edzard Ernst MD, PhD, FMed Sci, FSB, FRCP, FRCP(Edin)

Their comments include the following:

· Ms Aniftos: “Having reviewed the specifications of the BICOM device, I find that its inclusion on the ARTG as a ‘biofeedback device’ is erroneous”;

· Dr Slawecki: “the BICOM device does not fit the criteria of a legitimate biofeedback device”;

· Dr Roberts: “The claims of how the BICOM and CyberScan work are preposterous.”Quantum physics” is not at work”;

· Professor Forgas: “The BICOM is NOT a biofeedback device and should be cancelled”; “The description of this device makes it crystal clear that it cannot possibly have any effective diagnostic or therapeutic function, and certainly has nothing at all to do with biofeedback.

“The claims made for the device amount to the worst kind of psychological manipulation, and their sole purpose is to mislead and exploit vulnerable people for financial gain. As a civilised society, we should not allow this kind of immoral exploitation to continue and the device should be banned forthwith”;

· Professor Ernst: “Bioresonance is not biologically plausible, not of proven effectiveness, potentially harmful and associated with exorbitant costs. I cannot recommend it for anyone or any purpose”.

Can I invite you to join me in a little thought experiment?

Think of a totally useless therapy. I would suggest homeopathy but there are always some who would disagree with this classification. I need a TOTALLY useless therapy, and one where we ALL can agree on the label.

What about ‘Potentised Toe-Nail Powder’ (PoToNaPo)?

PoToNaPo is made from nail clippings, thoroughly sterilised, ground to a powder, serially diluted and potentised. Does anyone claim this remedy to be effective for any condition?

No?

Splendid!

So, we all agree that PoToNaPo is completely ineffective.

Now imagine some charlatan claiming that PoToNaPo is a highly effective cancer cure. Let’s furthermore imagine that he is very successful with his claim.

(No, this is not far fetched! Think of Laetrile, Essiac, etc.)

Imagine our charlatan makes millions with PoToNaPo.

There would soon be some opposition to his quackery. The FDA would issue a statement that PoToNaPo is unproven. Perhaps the NEJM would publish an editorial saying something similar. Ethicists would frown publicly. And many sceptics would head to the pubs where clever guys would give talks about ‘the scandal of PoToNaPo’.

We all know it would happen, because it has happened with PoToNaPo-like remedies many times before.

______________

Now imagine a different scenario, namely one in which our charlatan does not claim that PoToNaPo is a cancer cure; imagine instead he had claimed that PoToNaPo is a holistic medicine that boosts your well-being via re-balancing your vital energies which, in turn, helps with anxiety which in turn might have positive effects on things like mild chronic pain, depressive mood, tension headache, insomnia, erectile dysfunction and many more symptoms of daily life.

Let’s furthermore imagine that our charlatan is very successful with these claims.

No, this is not far fetched! Think of … well … think of any SCAM really.

Imagine the charlatan makes millions with PoToNaPo.

What would happen?

  • He would be invited to conferences on integrative medicine.
  • Become an honorary member/sponsor of the ‘College of Medicine and Integrated Health’.
  • He would be interviewed on the BBC.
  • The Daily Mail would publish advertorials.
  • HRH would perhaps invite him for tea.
  • Trump might hint that PoToNaPo cures virus infections.
  • Ainsworth might buy his patent.
  • There could even be a gong waiting for him.
  • And yes … some sceptics would mutter a bit, but the public would respond: what’s the harm?

We all know that things of this nature might happen, because they have happened before with PoToNaPo-like remedies.

__________________

So what’s the difference?

In both scenarios, our charlatan has marketed the same bogus remedy, PoToNaPo.

In both scenarios, he has made unsubstantiated, even fraudulent claims.

Why does he get plenty of stick in the 1st and becomes a hero in the 2nd case?

Yes, I know, the difference is the nature of the claims. But the invention, production, marketing and selling of a bogus treatment, the lying, the deceit, the fraud, the exploitation of vulnerable people are all the same.

Why then are we, as a society, so much kinder to the charlatan in the 2nd scenario?

I think we shouldn’t be; it’s not logical or consequent. I feel we should name, shame and punish both types of charlatans. They are both dangerous quacks, and it is our ethical duty to stop them.

END OF THOUGHT EXPERIMENT

 

I should never claim that I know all the cancer quackery that is out there! Because I don’t. There are just too many of them; and a new one seems to crop up every week.

For instance, I did not know about POWERLIGHT, a SCAM that is being promoted against many serious diseases, including cancer. Here is what the website states:

The very word “cancer” for patients is such a heavy burden, that psychological support actualy is necessary when a patient gets such a diagnosis. In this section we are pleased and proud to set an end to this terrifying illness.

A lot of different tumors in current language are called cancer. A cancer is based on epithelian tissue. This tissue occures in different organs. Because of that we find this tumore: as an

– Anal carcinoma

– Bronchial carcinoma

– Testicle carcinoma

– Laryngeal cancer

– Colon cancer

– Oesophageal cancer

– Gastric cancer

– Breast cancer

– Kidney carcinoma

– Ovary carcinoma

– Pancreas carcinoma

– Pharynx (throat) carcinoma

– Prostate carcinoma

Cancer is one of the most dreaded diseases we know.

We found the possibility to heal every kind of cancer, anyway what staging the tumor has. Also patients in the final stadium feel better after the third ampoule* and will be healed completly. The first ampoule brings a patient a better psychic situation.

For other tumors we have special medicines in our product list. Before taking Powerlight medicine it is necessary to have an exact diagnosis from a hospital. For example it was necessary to develope against carcinomas in the childhood other cluster stuctures – this is now our drug KIC. Tumores spreading from other tissues are to be treated with Powerlight NR, Powerlight H+NH and Powerlight LE.

If a patient started his treatment with conventional chemotherapy, the side effects will be bettered, when the patient gets Powerlight EG. The intake of Powerlight CA and Powerlight EG in the same period is not possible. In serious cases it has to be proved, whether the dangerous situation is caused primarily by the tumor or by the chemotherapy. According to this the heaviest burden has to be treated first.

All tumores that are not cancers, will not be healed by Powerlight CA. In these cases find an other correct medicine under  “Product list” in this homepage.

And how does POWERLIGHT work? The website provides the amazing answer:

The scientific background of our products is the physics of antimatter. With the help of positron radiation we can represent order patterns of living matter. Antimatter is able to copy patterns of organisms, when we put them into the electromagnetic field of antimatter. Such patterns show irregularities in the living matter. Normally living matter is structured by strict order patterns. The irregularities are causes of illness. Powerlight reconditions order patterns of living systems, because these order patterns also by heavy illnesses are not destroyed but only overlapped. The original order patterns are guide rails of the electron transfer by Clusters.

It has been reported that POWERLIGHT and some of the quacks offering it are now being sued in Austria after several cancer patients died who were naïve enough to believe this BS. According to the website, the firm originates in the Netherlands, however, MedWatch found out that it is not registered there either. This probably means that, officially, the firm does not even exist.

 

 

*the content has been analysed and seems to be a pure isotonic NaCl solution.

During the last few months, I have done little else on this blog than trying to expose misinformation about COVID-19 in the realm of so-called alternative medicine (SCAM). However, the usefulness and accuracy of most viewed YouTube videos on COVID-19 have so far not been investigated. Canadian researchers have just published a very nice paper that fills this gap.

They performed a YouTube search on 21 March 2020 using keywords ‘coronavirus’ and ‘COVID-19’, and the top 75 viewed videos from each search were analysed. Videos that were duplicates, non-English, non-audio and non-visual, exceeding 1 hour in duration, live and unrelated to COVID-19 were excluded. Two reviewers coded the source, content and characteristics of included videos. The primary outcome was usability and reliability of videos, analysed using the novel COVID-19 Specific Score (CSS), modified DISCERN (mDISCERN) and modified JAMA (mJAMA) scores.

Of 150 videos screened, 69 (46%) were included, totalling 257 804 146 views. Nineteen (27.5%) videos contained non-factual information, totalling 62 042 609 views. Government and professional videos contained only factual information and had higher CSS than consumer videos (mean difference (MD) 2.21, 95% CI 0.10 to 4.32, p=0.037); mDISCERN scores than consumer videos (MD 2.46, 95% CI 0.50 to 4.42, p=0.008), internet news videos (MD 2.20, 95% CI 0.19 to 4.21, p=0.027) and entertainment news videos (MD 2.57, 95% CI 0.66 to 4.49, p=0.004); and mJAMA scores than entertainment news videos (MD 1.21, 95% CI 0.07 to 2.36, p=0.033) and consumer videos (MD 1.27, 95% CI 0.10 to 2.44, p=0.028). However, they only accounted for 11% of videos and 10% of views.

The authors concluded that over one-quarter of the most viewed YouTube videos on COVID-19 contained misleading information, reaching millions of viewers worldwide. As the current COVID-19 pandemic worsens, public health agencies must better use YouTube to deliver timely and accurate information and to minimise the spread of misinformation. This may play a significant role in successfully managing the COVID-19 pandemic.

I think this is an important contribution to our knowledge about the misinformation that currently bombards the public. It explains not only the proliferation of conspiracy theories related to the pandemic, but also the plethora of useless SCAM options that are being touted endangering the public.

The authors point out that the videos included statements consisting of conspiracy theories, non-factual information, inappropriate recommendations inconsistent with current official government and health agency guidelines and discriminating statements. This is particularly alarming, when considering the immense viewership of these videos. Evidently, while the power of social media lies in the sheer volume and diversity of information being generated and spread, it has significant potential for harm. The proliferation and spread of misinformation can exacerbate racism and fear and result in unconstructive and dangerous behaviour, such as toilet paper hoarding and mask stealing behaviours seen so far in the COVID-19 pandemic. Consequently, this misinformation impedes the delivery of accurate pandemic-related information, thus hindering efforts by public health officials and healthcare professionals to fight the pandemic.

Good work!

I suggest to critically evaluate the statements of some UK and US politicians next.

 

Just when I thought I had seem all of the corona-idiocy, I found this paper by Dr Kajal Jain MD Homoeopathy (Materia Medica ) Medical Officer under Uttar Pradesh Public Service Commission. It promotes specific nosodes and other homeopathics against the current pandemic. In my view, it discloses a new dimension of the delusion which seems to have engulfed so many homeopaths. Allow me to copy a short passage from it:

TUBERCULINUM

A glycerine extract of a pure cultivation of tubercle bacilli (human).

As per Lectures on Homoeopathic Materia Medica by Dr Kent (page 1000) the Tuberculin nosode can prevent TB infection in those having predisposition to miasma. “If Tuberculinum bovinum be given in 10m, 50m, and CM potencies, two doses of each at long intervals, all children and young people who have inherited tuberculosis may be immuned from their inheritance and their resiliency will be restored

Burnett treated 54 cases of different types of TB Tuberculinum(Tub)/Bacillinum(Bac) 3

As stated in an article published in economic times ,countries without universal policies of BCG vaccination, such as Italy, the Netherlands, and the United States, have been more severely affected compared to countries with universal and long-standing BCG policies,” noted the researchers led by Gonzalo Otazu, assistant professor of biomedical sciences at NYIT.

The study noted that Australian researchers have recently announced plans to fast track large-scale testing to see if the BCG vaccination can protect health workers from the coronavirus.

The team compared various nations’ BCG vaccination policies with their COVID-19 morbidity and mortality and found a “significant positive correlation” between the year when universal BCG vaccination policies were adopted and the country’s mortality rate.

Iran, for instance, which has a current universal BCG vaccination policy that only started in 1984, has an elevated mortality rate with 19.7 deaths per million inhabitants, they said.

In contrast, Japan, which started its universal BCG policy in 1947, has approximately 100 times fewer deaths per million people, with 0.28 deaths, according to the study.

Brazil, which started universal vaccination in 1920 has an even lower mortality rate of 0.0573 deaths per million inhabitants, the scientists noted.

The researchers noted that among the 180 countries with BCG data available today, 157 countries currently recommend universal BCG vaccination.

The remaining 23 countries have either stopped BCG vaccination due to a reduction in TB incidence or have traditionally favoured selective vaccination of “at-risk” groups, they said.4

Thus we can see that Tuberculinium is reputed since a long timeas homoeoprophylactic in place of BCG. So Tuberculinum in high potency can act as an effective and dependable prophylactic in corona Virus .

PNEUMOCOCCINUM-

Pneumococcinum is reputed to prevent pneumonia. 5

In end stages OF CORONA VIRUS when we encounter symptoms like high fever ,pneumonia,pleurisy , -Pneumococcinum can be considered due to it being most similar to exisiting disease condition. Historically Pneumococcinum along with Influenzinum has been seen in eliciting drastic immunological responses in disease conditions following flu since it creates picture of pneumonia..

INFLUENZINUM and Oscillococcinum

Influenzinum is reputed to prevent flu and flu line symptoms 5

Oscilllococcinum –prepared from liver of wild duck has been observed to reduce course of illness due to influenza this it can be included as one of the probable medicnes in treatment of corona virus in earlier stages 6

A study conducted by Colombo GL1, Di Matteo S2 et al suggests that the treatment with Oscillococcinum could be helpful in preventing RTIs and improving the health status of patients who suffer from respiratory diseases7

Comparison of Allopathic vaccines and Nosodes

Allopathic vaccines are isopathic in nature, cude in nature unlike nosodes which are dynamic in nature with deeper penetrative abilities ..Nosodes when administered mimic the sickness and by natures law of cure prevent and treat illness.Nosodes being the same as original disease are more similar to the disease condition and are deeper in action since they are potentised

Thus realising effectiveness of nosodes in prevention and treatment of epidemics Nosodes are suggested as one of the probable approaches for COVID 19

This paper is so full of utter nonsense that I am unable to point it all out in a short blog-post. I trust you can easily identify it yourself. Let me therefore just focus on one specific point.

I did highlight reference 6 in the text for a special reason. Here is the reference provided by Dr Jain:

6. Vickers AJ, Smith C. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database Syst Rev 2000;(2):CD001957

It does not take much research to find out what is wrong with it. It refers to a Cochrane review which, of course, seems most laudable. To be precise, it refers to the 2000 version of this review which concluded that Oscillococcinum probably reduces the duration of illness in patients presenting with influenza symptoms. Though promising, the data are not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndrome. Further research is warranted but required sample sizes are large. Current evidence does not support a preventative effect of homeopathy in influenza and influenza-like syndromes.

This review is today obsolete, as it has meanwhile up-dated no less than 4 (!) times.

The latest version of this review is from 2015 (authored by well-known proponents of homeopathy) and concluded as follows: There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum® in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum® could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling. There was no evidence of clinically important harms due to Oscillococcinum®.

It is virtually impossible to not realise all this when accessing the reviews via Medline. And that leads me to fear that the author of the above paper, Dr Kajal Jain MD Homoeopathy (Materia Medica ) Medical Officer under Uttar Pradesh Public Service Commission, is not just deluded, but fraudulent.

For complete newcomers to this blog, I should preface this post with four statements of fact (evidence to support them can be found in numerous previous posts on this blog or in my book entirely dedicated to homeopathy):

  1. Homeopathic remedies are usually so highly diluted that they do not contain enough active molecules to have any effect whatsoever.
  2. The evidence from clinical trials fails to show that homeopathic remedies are more than placebos.
  3. Boiron is the world’s largest manufacturer of homeopathic remedies.
  4. Therapeutic claims made for homeopathic remedies are bogus.

_____________

BOIRON USA, seem to employ someone who does little else but tweet irresponsible advertisements that mislead and endanger the public. On 5/5/2020, for instance, I saw within a matter of just hours in my Twitter timeline dozens of advertisements by Boiron USA . I copied a few examples:

  • Oscillococcinum USA Clinical studies show that Oscillococcinum reduces the duration and severity of flu-like symptoms such as body aches, headache, fever, chills, and fatigue.*
  • Boiron USA Ignatia amara relieves a lump in throat, hypersensitivity or intolerance to light, noise, or smells, frequent sighing, difficulty breathing, spasms, & cramps related to stress. It may help those who feel moody or emotional from added #stress. Claim basis: bit.ly/2VaVt0o
  • Boiron USA Calendula officinalis (Garden marigold) offers more than its good looks. This flower has healing power! Calendula has been used for centuries as a healing and soothing substance for skin irritations like cuts, scrapes, chafing, minor burns and sunburn. bit.ly/2srZqPI

And here are four more from 6/5/2020:

  • #Homeopathic Sabina relieves profuse and painful periods with red blood clots and pain spreading to the tops of the thighs. Dosage: Dissolve 5 pellets under the tongue 4 times a day. Decrease frequency with improvement. Claim basis: bit.ly/2I1L3sN
  • Colocynthis 6C relieves abdominal & menstrual cramps improved by bending over, strong pressure and heat. Dosage: Dissolve 5 pellets under the tongue every 30 minutes. Decrease frequency with improvement. Claim basis: bit.ly/2oMa9RX
  • Caulophyllum thalictroides 30C relieves menstrual cramps occurring at the onset of periods, with scanty flow. Dosage: Dissolve 5 pellets under the tongue 4 times a day. Decrease frequency with improvement, Claim basis: bit.ly/2q7Ea2Q
  • #Homeopathic Cimicifuga racemosa 6C relieves cramps associated with #PMS and aggravated by cold and humidity. Dosage: Dissolve 5 pellets under the tongue twice a day. Decrease frequency with improvement. Claim basis: bit.ly/2Kj57Yk

(Please do click on the links for ‘claim basis’ and be surprised!)

As far as I can tell, Boiron USA have been doings this sort of thing incessantly since years. Why does someone not stop them? All of these advertisements make claims that are bogus, unethical, and potentially harmful for many consumers. How can this be legal? Should there not be some sort of consumer protection?

But perhaps there is something all of my US readers can do quite effortlessly: on their website, Boiron USA state that they are

committed to providing top-quality products to our customers. Subject to the Terms, Conditions and Limitations below, if within 30 days of purchase, you are not completely satisfied with our medicines for any reason, we’ll give you your money back.

To receive your refund, please send us the following items within 30 days of purchase at the address below:

    • Your name, address and telephone number
    • The original UPC from the Boiron product purchased
    • The original dated cashier register receipt with the purchase price circled

Boiron Information Center
Attn: Refunds
4 Campus Boulevard
Newtown Square, PA 19073

So, how about buying the preparations advertised and then insisting on a refund, if they did not achieve what was promised in their advertisement on Twitter? That might soon stop them misleading the public!

Guest post by Christian Lehmann

It’s the end of February. We see the first death, in the Oise department, near Paris, of a French citizen who has not recently travelled abroad. For doctors concerned about what is happening in China, this is the red alert. In spite of of the little notices posted by the health minister, Agnes Buzyn, at airports, the coronavirus has made it onto French soil. Nobody knows at that point how it will spread. Almost nobody, apart from those responsible for it, yet knows that France has completely run down its stocks of masks. Doctors themselves do know that the health service has only held out, for as long as it has, on the backs of its care personnel. Some are assessing the scale of what is to come.

The announcement by Didier Raoult about the spectacular effectiveness of a synthetic antimalarial, chloroquine, has brought enormous relief, followed immediately for many of us health professionals by growing doubts about an accumulation of errors: Raoult denies any toxicity, urges people to “fall upon” a medication requiring sensitive handling. When we locate the Chinese article on which Didier Raoult is basing his crisis communication, we are stupefied. No need for specialised knowledge in statistical methodology to understand that there is something seriously wrong. No numerical data. Nobody knows what dosage has been given, to what type of patient, nor how many have been treated. The article has not been “peer reviewed”, that is to say reviewed by professional equals; decoded, it has the effect of a simple announcement. So of course at this chaotic time we tell ourselves that, given a revelation of such importance, the Chinese wanted to act as quickly as possible, to inform the whole world. And Didier Raoult, who routinely advises, as he explains with delicious modesty, the Chinese, « the world’s best virologists », has probably been entitled to the first fruits of this revelation.

On Youtube, on 28 February, he posts a weird interview, “Why would the Chinese be mistaken?”, in which he repeatedly takes up his interviewer with obvious irritation. “No, that’s not the question that you should be asking me. You should be asking me….” An informal group of doctors and tweeters pass around the link. We are rubbing our eyes in disbelief. What Didier Raoult is passing off as an interview is nothing more then an audience accorded to one of his media aides. We advise him, sarcastically, to make a professional cut of the video before broadcasting it. An hour later the video disappears and returns in a more professional form which could create the illusion of a genuine interview. And rapidly, in the Press which is beginning to turn its microphones towards the Professor from Marseille, he modifies his stance, without ever acknowledging the radical changes.

Chloroquine, spectacular and miraculous only yesterday, disappears as if by magic, replaced from one day to the next by hydroxychloroquine (Plaquenil), a different medicine, less common. Though its chemical structure is close to that of the antimalarial medication, hydroxychloroquine is used primarily in rheumatic conditions such as rheumatoid polyarthritis, or immune conditions such as lupus. So at least it isn’t lying around in large quantities in medicine cabinets. And its cardiac toxicity, very real, is slightly lower then that of chloroquine. Didier Raoult puts forward HCQ as an immense discovery, continuing in his usual manner to ridicule his detractors. “The doctors who criticise me are neither in my field nor up to my weight”. He flays the inaction of embittered petty health officials, only fit to follow the diktats of the authorities, who, bogged down in their catastrophic crisis management, dare not intervene. And his posturing as a refractory Gaul, a loudmouth taking on the system, gains sympathy, from those to whom he gives hope, from those who understand that the State does not tell them everything, and from those looking for a hero to fit in with their stereotypes: the man on his own against the establishment, the White Knight taking on Big Pharma, the Hippocratic colossus besieged by hordes of soulless ants.

No one among those who hold out their microphones to him, not one asks him the question which we are all asking, GPs, cardiologists, pharmaceutical specialists, emergency specialists, resuscitation specialists – by what sleight of hand has Didier Raoult exchanged his miracle medicine, in 48 hours, openly and publicly? And how is it that no one has noticed the sleight-of-hand? Has this man who makes such a big deal of his image on social networks suddenly become aware of the risk of being confronted about chloroquine with a justifiable public outcry and with deaths by self-medication?

While the World Health Organisation is sounding alarm bells, in the context of overall mistrust with regard to scientific opinion, of confrontation with regard to government, of growing awareness ( belated and sometimes disproportionate) of the influence of Big Pharma, and as the initial fear gives way to real panic for some with the registration of each new case, Didier Raoult piles up Facebook likes, fans, sites to his glory. And for us, fearful, begins the long registration of flagrant mistruths delivered as revealed truths, which this professor will never have the honestly to set right.

For Didier Raoult, a minimum of intellectual integrity would demand that he admits having changed horses in midstream. That he admits that the concern of his despised detractors was well founded, with respect to chloroquine to which many have access without knowing its dangers ( Nivaquine is very often used in suicides). And, because Didier Raoult withdraws nothing, he continues to stash away all the profits of his media coverage. Every supporter of the Wise Man of Marseille piles in with testimony. Their brother, sister, uncle, the father-in-law of their hairdresser has been taking the Professor’s medicine ( Which one? ) for eight years in Africa and has never had a problem, so that’s the real proof that his detractors are just jealous, or, even worse, backed by “the lobbies”.

And untiringly we repeat the fundamental truths:

  • Yes chloroquine has existed for years
  • Yes it is widely used
  • But for a different treatment, the prevention of malaria
  • And in dosages 5 to 10 times smaller
  • And in large dosages it causes cardiac arrest
  • And it has never been effective in fighting a virus
  • Not this virus nor any other
  • And the same is true for hydroxychloroquine
  • In fact it’s rather the opposite

In fact what is being patiently stated by the upholders of the scientific method is very counter-intuitive, almost inaudible, because they are telling worried and disorientated people, who have put their trust and their hope in one man, that in his assertions………nothing makes sense.

There are uncounted different forms of bogus so-called alternative medicines (SCAMs), and many have been discussed on this blog. What do I mean by ‘bogus’? A bogus SCAM is one, in my view, that is being promoted for conditions for which it does not demonstrably generate more good than harm.

Ten popular examples are:

  • alternative cancer ‘cures’,
  • applied kinesiology,
  • Bach Flower Remedies,
  • CEASE,
  • chiropractic,
  • detox treatments,
  • homeopathy,
  • osteopathy,
  • paranormal or energy healing techniques,
  • slimming aids.

These treatments are diverse in many ways: history, basic assumption, risks, etc. But they nevertheless tend to have certain features in common:

  1. Most SCAMs originate from the ideas developed by a single, often charismatic individual who proclaimed to have seen the light. Think of Gerson, Bach, Palmer, Hahnemann, Still.
  2. They are recommended by enthusiasts as a panacea, a ‘cure all’.
  3. They are heavily promoted by celebrities, hyped by the press and marketed via books or the Internet, but they are far less or not at all supported by published studies in the peer-reviewed medical literature.
  4. The clinical trials of SCAM that have been published are flimsy, lack independent replication, yet are celebrated by proponents as though they represent robust evidence.
  5. SCAMs target either the most desperately ill patients who understandably tend to cling to every straw they can find. Or they go for the ‘worried well’ who have nothing truly wrong with them and plenty of cash to waste.
  6. Proponents of SCAM use scientific-sounding terminology, while simultaneously displaying a profoundly anti-scientific attitude.
  7. Entrepreneurs of SCAM are efficient at selling false hope at excessive prices.
  8. SCAMs sometimes seem to work because many of the therapists are skilled at maximising the placebo-response.
  9. SCAM is awash with conspiracy theories, for instance, the notion that ‘the establishment’ is supressing SCAM. (If a SCAM ever showed real promise, it would rapidly scrutinised by researchers and, if effectiveness were confirmed, adopted by conventional medicine. The notion of an alternative cure for any disease is idiotic, because it presupposes that conventional healthcare professionals shun a potentially valuable treatment simply because it emerged from elsewhere.)
  10. Most SCAMs can do direct harm. For instance, oral treatments can be toxic or interact with prescription drugs. Or spinal manipulations can cause a stroke. Or acupuncture can cause a pneumothorax.
  11. SCAMs are dangerous even if they do not cause direct harm. There are many examples of people who died needlessly early because they used SCAM as an alternative to conventional medicine (Steve Jobs is a prominent example).
  12. Moreover, SCAMs cause harm by undermining the principles of EBM and, more importantly, by undermining rational thinking in our society.
  13. SCAM practitioners violate fundamental rules of medical ethics on a daily basis. One could even argue that the ethical practice of SCAM is rarely possible.

 

This study by Australian pharmacists, assessed the quality and relevance of community pharmacists’ information gathering (questioning), counselling and product selection when interacting with customers requesting a s0-called alternative medicine (SCAM) product for stress and consequently determine whether Australian pharmacy practice indicates the need for guidelines similar to those provided for ‘pharmacy only’ (S2) and ‘pharmacist only’ (S3) medicines.

A covert simulated patient (SP) was used to investigate the response of pharmacists to a request for a natural product for stress. The SP documented the details of the pharmacist-simulated patient interaction immediately on leaving the pharmacy and then re-entered the pharmacy to debrief the pharmacist. The quality of the interaction was scored as a Total CARE (check, assess, respond, explain) Score, based on anticipated questions and counselling advice. The appropriateness of the product was scored as a Product Efficacy Score, based on evidence-based literature.

Data from 100 pharmacies was provided. Information gathering illustrated by the questioning components Check and Assess (C and A) of the total CARE score by pharmacists was poor. The number of questions asked ranged from zero (13 pharmacists) to 7 (four pharmacists), the average being 3.1 (SD 1.9). Provision of advice was generally better (a description of the suggested product was offered by 87 pharmacists) but was lacking in other areas (duration of use and side effects were explained by only 41 and 16 pharmacists respectively). The most common product suggested was B-group vitamins (57 pharmacists) followed by a proprietary flower essence product (19 pharmacists). A two-step cluster analysis revealed two sub-groups of pharmacists: one cluster (74 pharmacists) with a high Total CARE score provided an appropriate product. The other cluster (20 pharmacists) had a low total CARE score and provided an inappropriate product.

The authors concluded that the pharmacy visits revealed major shortcomings in questioning, counselling and product recommendation. There is a need to develop guidelines for pharmacists to make evidence-based decisions in recommending SCAMs.

This paper offers a host of interesting information. For instance, it reveals that almost all pharmacists recommended at least one product for sale, about half of them recommended more than one. Considering that the evidence for most of the products in question is weak (to say the least), this seems concerning.

The second most recommended product, the ‘Bach Rescue Remedy‘, is perhaps a good case in point. There is no evidence that it has any effect on stress or any other condition. As the product contains no active ingredient, it is also implausible to assume it might work beyond placebo. Yet, many pharmacists are happy not only to sell it to the unsuspecting public, but even to recommend it to a customer who seeks out their advice.

I find this quite intolerable.

The paper thus confirms the point I have made repeatedly on this blog and elsewhere: community pharmacists seem to behave like commercially motivated shopkeepers, yet they are healthcare professionals who have to abide by an ethical code. When confronted with this overt conflict of interest, their vast majority seem to opt for violating their professional ethics in favour of profit.

I fail to understand why, despite these facts being well-known for so long, the professional organisations of pharmacists are doing do very little to rectify this appalling situation.

Wouldn’t it be wonderful, if we had a treatment that reduces the risk of getting infected with the corona-virus? Well, this paper claims that there is one. Here is its abstract:

Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed ancient classics and human studies.

Methods

Historical records on prevention and treatment of infections in CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February, 2020. Research evidence included data from clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases.

Results

The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi’s Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36, 95% confidence interval 0.24–0.52; n=4). For prevention of COVID-19, 23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao).

Conclusions

Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.

So, what should we make of this conclusion?

To provide an evidence-based answer, I tried to look up the original studies cited in the article. The links provided by the authors seem to be all dead except one which leads to a paper published in the infamous JCAM. Here is its abstract:

Objectives: To investigate the efficacy of an herbal formula in the prevention of severe acute respiratory syndrome (SARS) transmission among health care workers. The secondary objectives are to investigate quality of life (QOL) and symptomology changes among supplement users, and to evaluate the safety of this formula.

Design: Controlled clinical trial.

Settings: Hong Kong during epidemic of SARS.

Subjects: Two cohorts of health care workers from 11 hospitals in Hong Kong, 1 using an herbal supplement for a 2-week period (n = 1063) and a control cohort comprising all other health care workers who did not receive the supplement (n = 36,111) were compared prospectively.

Interventions: Taking an herbal supplement for a 2-week period.

Outcome measures: SARS attack rates and changes in quality of life and influenza-like symptoms were also examined at three timepoints among herbal supplement users.

Results: None of the health care workers who used the supplement subsequently contracted SARS compared to 0.4% of the health care workers who did not use the supplement (p = 0.014). Improvements in influenza-like symptoms and quality of life measurements were also observed among herbal supplement users. Less than 2% reported minor adverse events.

Conclusion: The results of this pilot study suggest that there is a good potential of using Traditional Chinese Medicine (TCM) supplements to prevent the spread of SARS.

How can I be polite and still say what I think about this article? Perhaps by stating this: THIS STUDY WAS INCAPABLE OF INVESTIGATING THE ‘EFFICACY’ OF ANYTHING AND ITS RESULTS ARE NOT CONVINCING.

So, are the Chinese authors correct when concluding that Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population?

No, I don’t think so! And I even feel that it is irresponsible in the current situation to misguide consumers, patients, scientists and decision-makers into believing that TCM offers an answer to the pandemic.

 

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