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

prevention

1 3 4 5 6 7 51

So-called alternative medicine (SCAM) interventions are growing in popularity and are even advocated as treatments for long COVID symptoms. However, comprehensive analysis of current evidence in this setting is still lacking. This study aims to review existing published studies on the use of SCAM interventions for patients experiencing long COVID through a systematic review of randomized controlled trials (RCTs).
A comprehensive electronic literature search was performed in multiple databases and clinical trial registries from September 2019 to January 2023. RCTs evaluating efficacy and safety of SCAM for long COVID were included. Methodological quality of each included trial
was appraised with the Cochrane ‘risk of bias’ tool. A qualitative analysis was conducted due to heterogeneity of included studies.

A total of 14 RCTs with 1195 participants were included in this review. Study findings demonstrated that SCAM interventions could benefit patients with long COVID, especially those suffering from

  • neuropsychiatric disorders,
  • olfactory dysfunction,
  • cognitive impairment,
  • fatigue,
  • breathlessness,
  • mild-to-moderate lung fibrosis.

The main interventions reported were:

  • self-administered transcutaneous auricular vagus nerve stimulation,
  • neuro-meditation,
  • dietary supplements,
  • olfactory training,
  • aromatherapy,
  • inspiratory muscle training,
  • concurrent training,
  • online breathing programs,
  • online well-being programs.

The authors concluded that SCAM interventions may be effective, safe, and acceptable to patients with symptoms of long COVID. However, the findings from this systematic review should be interpreted with caution due to various methodological limitations. More rigorous trials focused on CAM for long COVID are warranted in the future.

Such wishy-washy conclusions seem to be popular in the fantasy land of SCAM. Yet, they are, in my view, most ojectionable because:

  1. they tell us nothing of value;
  2. that something “MAY BE EFFECTIVE” has been known before and cannot be the result of but is the reason for a systematic review;
  3. a review of 14 RCTs of almost as many interventions cannot possibly tell us anything about the SAFETY of these treatments;
  4. it also does not provide evidence of effectiveness and merely indicates a lack of independent replications;
  5. if the abstract mentions an assessment of the study rigor, one expects that it also informs us about this important aspect.

Once we do come around looking at the methodological quality of the primary studies we realize that it is mostly miserable. This means that the conclusions of the review are not just irritating but plainly misleading. Responsible researchers should have concluded along the following lines:

The quantity and the quality of the evidence are both low. Therefore, the effectiveness and safety of SCAM interventions for long COVID remains unproven.

PS

This project was financially supported by The HEAD Foundation, Singapore and in part by the grant from the NIH R61 AT01218.

Shame on the authors, journal editors, peer-reviewers, and funders of this dangerous nonsense!

Guest post by Ken McLeod

Readers will recall that Barbara O’Neill is an Australian health crank, completely unqualified in anything, who is subject of a Permanent Prohibition Order issued by the New South Wales Health Care Complaints Commission, (HCCC),[1] preventing her from engaging in any health-related activity, including ‘health education,’ in Australia. The NSW Public Health Act 2010 provides that it is an offence for a person to provide ‘health education’ in contravention of a prohibition order, with a fine of $60,500 AUD ($38,151 USD, 36251 Euros) for an individual or imprisonment for 3 years, or both, or $121,000 AUD for a corporation.

For jurisdictional reasons that Order does not apply outside Australia and for several years she been touring the world giving health education lectures. The latest was a lecture tour of Ireland.[2] Despite the thorough debunking of her fruitloop beliefs by the HCCC,[3] she has maintained them and continues to give the ‘health education’ that was so dangerous that it led to the Prohibition Order in Australia.

Her Irish ‘health education’ lectures were live-streamed to people in Australia who paid the 20 Euro fee, and one was recorded by us.[4]

A transcript was made and is available online.[5] Her statements were analysed and some comments are made as follows. Alas, we didn’t have time to take a deep dive of her lecture to find the best references, but the following shows that an amateur with limited time and resources can prove that she does not know what she is talking about and that her advice is dangerous, even life-threatening.

It is up to the health regulators and immigration authorities in each country to act on her activities there, but so far none outside Australia have done so.

So a quick analysis of her ‘lecture’ in Dublin on 27 September 2023 shows that O’Neill has learned nothing from her experience with the HCCC. Some comments:

1. O’Neill and her husband, after the Prohibition Order was issued, changed the name of their facility from ‘Misty Mountain Health Retreat’ to ‘Misty Mountain Lifestyle Retreat’ to avoid the jurisdiction of the HCCC. However on four occasions in her lecture O’Neill referred to it as a ‘health retreat.’ 00:07:23 , 00:15:48, 01:30:04, 01:40:16.

2. At 00:12:53 O’Neill claims that the Amish don’t get autism. That is false, as explained by AP Factcheck. [6]

3. At 00:12:54 O’Neill claims that the Amish, ‘They don’t vaccinate their Children. Did you know that they don’t vaccinate their Children and yet they don’t get autism Very rare. Maybe 1%. And often that’s because of chemical exposure. There is always a reason. So why are vaccinations causing autism? Well, it’s neurotoxins, the neurotoxins. ‘

False; Amish do vaccinate their children. [7] However, studies have documented cases of autism, diabetes and cancer among the Amish, albeit at lower rates in some cases than the broader population and for reasons that are unrelated to their vaccination status. These reasons include the cultural norms and customs that may be playing a role in the reporting style of caregivers. [8] O’Neill is engaging in cherry-picking on a grand scale here.

4. At 00:13:37 O’Neill claims that ‘there are still two more neurotoxins’ (In vaccines.) Because children are still autistic. There’s formaldehyde, and there is aluminium, both neurotoxins.’

This is scaremongering disinformation. The CDC says ‘Formaldehyde is diluted during the vaccine manufacturing process, but residual quantities of formaldehyde may be found in some current vaccines. The amount of formaldehyde present in some vaccines is so small compared to the concentration that occurs naturally in the body that it does not pose a safety concern.’ As for aluminium, the CDC says ‘Ingredients like aluminum salt help boost the body’s response to the vaccine.’ The CDC says that both are safe. [9]

5. At 00:15:01 O’Neill claims ‘did you know that the milk in the supermarket if you give that to a newborn baby cow, that cow will die?’

I can find no reference supporting that and I suggest that it is pure fantasy.

6. At 00:18:29 O’Neill claims that ‘parents discover that they put their trust in the princes and vaccinated their child. Now their child has epilepsy. Now their child has autism.’

This is misleading panic-mongering that is a misrepresentation of the science. The Royal Australian College of General Practitioners says ‘Seizures and status epilepticus can occur within 14 days following administration of inactivated and live-attenuated vaccines. These vaccine-proximate seizures can undermine parental confidence in vaccine safety and affect further vaccination decisions. Vaccine-proximate status epilepticus (VP-SE) is uncommon but may be the first manifestation of genetic developmental epileptic encephalopathies, including Dravet syndrome.’ So ‘epilepsy’ may be first encountered [10] following vaccination but the root cause is genetic.

7. At 00:20:27 O’Neill says that she would like to suggest that no child would be vaccinated, because the fact is, our body was designed to heal itself.

This is pure crazy antivax propaganda, unsupported by the facts.

8. At 00:22:01 O’Neill claims ‘skin cancer has only been around in about the last 80 years, and you know what they’re finding today? That vitamin D deficiency is a big contributing back factor to skin cancer’.

The first claim is false; the science shows that skin cancers have been around ‘since the beginning of time.’ [11]

As for the second claim, the research published at the US National Library of Medicine shows that O’Neill’s advice is dangerous. ‘It is, therefore, preferable and safer to obtain adequate levels of vitamin D through diet than through sun exposure. In fact, it is currently accepted that dietary and supplemental vitamin D is functionally identical to that produced after UV exposure, being more reliable and quantifiable (the risks of keeping high levels of vitamin D have not been extensively studied) source of this vitamin.’ And ‘Neither natural nor artificial sun exposure should be encouraged as the main source of vitamin D.’ [12]

9. At 00:23:18 O’Neill disputes claims that ‘cholesterol causes heart disease. Well, it’s been going for 40 years now, and it still hasn’t proven that. But you know what? It has proven that people with high cholesterol levels don’t get Alzheimer’s.’

O’Neill’s first claim points to the conflicting research as revealed by the Cochrane Collaboration. [13] As for her second claim, the research does not justify her claim that it is ’proven.’ The evidence is conflicting and as the Alzheimer’s Society of the UK say, ‘More research is needed to better understand this relationship and what it can tell us.’ [14] O’Neill’s conviction is not based on evidence.

10. At 00:34:41 O’Neill said that at Dublin airport ‘about 10 days ago,’ she was approached by a man who asked ‘Are you the Australian doctor? And I smiled.’

O’Neill did not correct him and allowed him to be duped into believing she is a real doctor. Despite having no qualifications in anything O’Neill has used the honorific title ‘Dr’ many times in social media,[15] so it is no surprise that he assumed she was a doctor. I can’t help but be confused by her use of the ‘Dr.’ Throughout her lectures she denigrates real doctors, and then tries to boost her credibility by adopting the title.

11. At 00:35:21 she claimed that with ‘epigenetics, you can actually turn your genes on or off.’…. ‘So Michael effectively turned those genes off with castor oil. Castor is very effective for for cataracts. Put it in your eye, one lady said. Is it safe? Does anyone ever ask that of the doctor? Is that drug safe? Then the people have been putting cholesterol in their eyes for centuries. It’s safe.’

Bollocks! As Consumer Lab says ‘Although eye drops containing castor oil may help improve symptoms of dry eye and blepharitis, there is currently no compelling evidence that applying castor oil to the eye can diminish cataracts.’ [16] And there is no evidence that Michael turned the genes off.

12. At 00:40:08 she refers to a woman who recently had a stroke. She says

‘… because she had a stroke, she was put on the protocol she was on put on statins. Cholesterol lowering medication with clear arteries. How much sense does that make? You don’t have. You don’t have to be a rocket scientist to work this out. Trust in your gut feeling trust in this incredible body that God has given you. Her blood was no longer thick. Her arteries are open now. And so she came to our retreat and I said, Well, I can’t tell you what to do. And I have no authority over your medication. Only you, and go. You and your doctor do. But this is what I would do. I would stop the blood thinning medication immediately because that aspirin causes brain bleeds, eye bleeds and stomach bleeds. Got that? And I would stop the statin drugs because that the side effect of statin drugs is Alzheimer’s dementia, uh, memory loss, muscle wasting. And they’ve just added another one, which is breast cancer, because all our sex hormones are made from cholesterols.’

O’Neill told a woman who had suffered a stroke to stop taking her life-saving medication! These medications are prescribed by highly qualified medical specialists based on the research. As the UK Stroke Association says, ‘Blood-thinning medications reduce your risk of stroke by helping to prevent blood clots from forming. You might be prescribed them after a transient ischaemic attack (TIA) or a stroke caused by a blockage (an ischaemic stroke, or clot).’[17] It is clear that O’Neill, who has no qualifications in anything, does not know what she is talking about.

As for her claim that the side effects of statins is breast cancer, the research shows the opposite. ‘While statins do not affect the incidence of most cancers, they do exert significant benefits on recurrence and survival in many cancer types, including breast cancer.’ [18]

13. At 42:48 O’Neill claims ‘If you are on cholesterol lowering medication and many have been deceived….’ As above, it is O’Neill who is doing the deceiving.

14. At 45:09 O’Neill claims that ‘If you stop your cholesterol lowering medication, there will be a side effect. Your memory will return. Your muscles will get stronger. Any little appearances of Alzheimer’s will start to ease.’

As above, the available research does not show that.

15. At 48:57 O’Neill claims ‘Why did they put fluoride in water? The claim was to harden the teeth. Has it hardened the teeth? Not at all. Has it reduced tooth decay? Not at all.’ And ‘But that fluoride is very hard on the kidneys, very hard on the liver.’

The research here is overwhelming; as the CDC says: ‘The CDC named community water fluoridation one of 10 great public health achievements of the 20th century.

‘Many research studies have proven the safety and benefits of fluoridated water. For  75 years people in the United States have been drinking water with added fluoride and enjoying the benefits of better dental health.

‘Drinking fluoridated water keeps teeth strong and reduces cavities (also called tooth decay) by about 25% in children and adults.’

As for O’Neill’s claim that fluoride is very hard on the kidneys, very hard on the liver,’ the research is inconclusive, and in fact the reverse may be true. Research shows ‘Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.’ So the science does not support O’Neill’s certainty.

16. At 48:57 O’Neill claims that ‘all body symptoms and body diseases and shows how dehydrating has a huge factor.’ O’Neill gives no evidence to support that huge claim.

17. At 01:00:20 O’Neill claims that a woman told her ‘I had the vaccine. Now I’ve got clots. Barbara, I had the vaccine. I can’t. I cannot even remember all the diseases that are arising. Have you noticed? And so many people were blackmailed into that vaccine.’ And ‘Is that (COVID19) a crisis? it’s not a crisis at all. And yet we’re seeing so many problems arising.’

O’Neill is dreadfully wrong here. COVID 19 was a crisis. How else would we describe a pandemic that is known to have killed at least 6,961,014 deaths, as reported to the WHO? [19] And what are the problems that we are seeing arising? Outside her imagination, that is.

18. At 01:00:20 O’Neill claims that ‘one man said, Show me the safety studies. They gave him three pages of blank paper. No safety studies, no safety studies at all.’ (On vaccines). And ‘drugs never cure disease.’ And a few lines later, again, ‘Drugs never cure disease.’

The allegation that ‘They (doctors) gave him three pages of blank paper’, is just so deranged. No doctor would do that because there are thousands of studies of vaccine safety.

O’Neill’s claim that there are no safety studies on vaccines is hopelessly wrong and dishonest. It’s one of the many anti-vax lies circulating on the internet, so beloved by the gullible. As the Australian Dept of Health and Aged Care say, ‘Research and testing is an essential part of developing safe and effective vaccines. In Australia, every vaccine must pass strict safety testing before the Therapeutic Goods Administration (TGA) will register it for use. Before vaccines become available to the public, they are tested on thousands of people who take part in large clinical trials.’ [20] It took me a few seconds on the internet to find an interesting research paper on HPV vaccines, including a section on safety. [21] O’Neill could do that so the inevitable conclusion is that she set out to deceive. As for ‘drugs never cure disease,’ that is so bizarre, so whacky, so deluded, that it almost not worth challenging. But I will anyway; medical professionals have seen drugs work billions of times, and I can testify that I was saved from a life-threatening illness due to cephalexin.

19. At 01:10:49 O’Neill claims ‘some (medications) can be stopped immediately, like your statin drugs and your blood thinners. Yeah, what do you take instead of statin drugs? Well, there’s no need, because cholesterol is not a problem.’

O’Neill’s advice here is life-threatening rubbish. As the Mayo Clinic says ‘Abruptly stopping an anticoagulant can increase your risk of a stroke.’ [22] As for her advice on cholesterol, see above.

20. At 01:15:39 O’Neill claims that there was ‘No diabetes on the planet til sugar was well established.’ And lack of nose-breathing causes ‘Chronic fatigue syndrome. There’s one cause; it’s lack of oxygen at the cellular level.’

Humans have gathered sugar since we first became homo sapiens and diabetes has always been a problem for us and other animals.

As for her claim that lack of nose-breathing causes ‘Chronic fatigue syndrome;’ the Mayo Clinic says ‘The cause of ME/CFS is unknown, although there are many theories. Experts believe it might be triggered by a combination of factors.’ They go on to list many possible causes but lack of nose-breathing is not one of them.[23]

21. At 01:26:08 O’Neill claims that a researcher ‘…. could turn cancer cells on and off by the amount of animal, pro and animal protein that he was giving’ and liver cancer could be prevented by ‘a simple diet and cancer weights were very low low compared to the city again, with that high meat diet….’ There is some truth in this, but it does not justify O’Neill’s other advice to avoid prescribed medications.

22. At 01:49:26 O’Neill claims ‘if someone has a rash and they put cortisone on it, what happens to the rash? It’s gone, but But it comes back in about another week. Is that right? Twice as bad.’ And ‘No drug can heal cancer. The body and the body alone when it’s given the right conditions can cause cancer to be conquered in the body.’ And ‘A fever is nothing to fear.’

O’Neill’s claim that ‘No drug can heal cancer’ is demonstrably wrong. Life expectancy following cancer treatment has improved vastly over the decades, largely due to better detection and prescribed medications. As the US National Cancer Institute (NCI) estimates, ‘due to improved detection and treatment, deaths have dropped 41 percent from 1989 to 2018, according to the ACS.’ [24]

As for O’Neill’s claim that ‘a fever is nothing to fear,’ the Victorian Dept of Health says ‘High fever (about 41.5°C or more) is extremely dangerous and could trigger convulsions.’ [25]

23. At 01:53:47 O’Neill claims that drug therapy is not working.

What does O’Neill mean by that? Does she mean that prescribed medication does not work? If she is repeating her earlier claim that ‘drugs never cure disease?’ I repeat my earlier rebuttal. That is so bizarre, so whacky, so deluded, that it almost not worth challenging. But I will anyway; medical professionals have seen drugs work billions of times, and I can testify that I was saved from a life-threatening illness due to cephalexin.

I’ll finish the analysis here because you have suffered enough.

Readers everywhere now have rock-solid evidence that should be presented to their national health regulators, showing that O’Neill, as the HCCC put it, ‘poses a risk to the health and safety of members of the public’ and therefore ‘should be permanently prohibited from providing any health services, whether in a paid or voluntary capacity.’ And you have rock-solid evidence that should be presented to venue managers who have allowed O’Neill to present life-threatening ‘education’ to the public on their premises, asking them to cancel the booking. It’s not hard; it was done in Ireland by members of the public. That led to cancellation of the booking, and a rush by O’Neill’s supporters to find a new venue.

References

1 https://www.hccc.nsw.gov.au/decisions-orders/public-statements-and-warnings/public-statement-and-statement-of-decision-in-relation-to-in-relation-to-mrs-barbara-o-neill

2 https://www.independent.ie/irish-news/controversial-wellness-coach-barbara-oneill-set-to-host-talk-in-ireland-this-month/a1781099169.html

3 https://www.hccc.nsw.gov.au/ArticleDocuments/216/Statement%20of%20Decision%20-%20Mrs%20Barbara%20ONeill.pdf.aspx

4 The video is available at https://rumble.com/v3lt611-barbara-oneill-positive-life-event-27th-september.html and a backup is available at https://www.dropbox.com/scl/fi/vqe9plhgjijunvl22kvb6/Barbara-ONeill-Positive-Life-Event-27th-September.mp4?rlkey=1kjyi9jdl8kfdp8kcdf1p4xba&dl=0

5 https://www.dropbox.com/scl/fi/csl95hg7gomr318nygotx/TRANSCRIPT-BARBARA-O-NEILL-POSITIVE-LIFE-EVENT-DUBLIN-27-SEPT-2023.pdf?rlkey=z2d5uh59fwagzdfdk30hvpauy&dl=0

6 https://apnews.com/article/fact-check-amish-covid-vaccines-cancer-diabetes-autism-356029928165

7 https://apnews.com/article/fact-check-amish-covid-vaccines-cancer-diabetes-autism-356029928165

8https://www.researchgate.net/publication/268144514_Prevalence_Rates_of_Autism_Spectrum_Disorders_Among_the_Old_Order_Amish

9 https://www.cdc.gov/vaccines/vac-gen/additives.htm

10 https://www1.racgp.org.au/ajgp/2020/october/seizures-following-vaccination-in-children

11 https://www.usatoday.com/story/news/factcheck/2023/08/03/false-claim-skin-cancer-has-only-been-around-for-60-years-fact-check/70515019007/

12 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709188/

13 https://s4be.cochrane.org/blog/2018/07/02/cholesterol-and-heart-disease-whats-the-evidence/

14 https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/cholesterol-and-dementia

15 https://www.facebook.com/people/Dr-Barbara-ONeill/100093111507726/

16 https://www.consumerlab.com/answers/castor-oil-eye-drops-for-cataracts/castor-oil-cataracts/

17 https://www.stroke.org.uk/resources/blood-thinning-medication-and-stroke

18 https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-018-1066-z#author-information

19 https://covid19.who.int/

20 https://www.health.gov.au/are-vaccines-safe

21 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565290/

22 https://connect.mayoclinic.org/blog/take-charge-healthy-aging/newsfeed-post/know-the-warning-signs-of-blood-thinner-complications/

23 https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490

24 https://www.healthline.com/health/breast-cancer/survival-facts-statistics#breast-cancer-stages

25 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fever#bhc-content

Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals.

In this study, an international team of researchers analyzed the relationship between endorsement of so-called alternative medicine (SCAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries:

  • Germany,
  • Finland,
  • Portugal,
  • France.

In total the sample amounted to 2,787 physicians.

The results suggest that, in all the participating countries, SCAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average SCAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another:

  • 24% in Germany,
  • 18% in France,
  • 10% in Finland,
  • 6% in Portugal.

These results constitute a call to consider health care professionals’ attitudes toward SCAM as a factor that could hinder the implementation of immunization campaigns.

The authors also point out that the link between SCAM endorsement and negative attitudes toward vaccines has been documented in previous research among the general public. A systematic review, which categorized arguments against vaccines retrieved from peer-reviewed articles and debunking texts published by international fact checking agencies, identified a category of arguments largely based on alternative health beliefs related to SCAM. This category was the third most common in the scientific and fact-checking literature. Furthermore, in a British study, anti-vaccination arguments related to SCAM were also among the most endorsed arguments by individuals. These results suggest that SCAM beliefs play an important role in individuals’ justification of their hesitant attitudes toward vaccines for both adults and children. Analyses of samples from the Australian, Finnish, American, and Spanish general populations found that positive attitudes toward SCAM were related to negative attitudes toward vaccines. In a recent large-scale study in 18 European countries, parental consultation with homeopaths was associated with higher vaccine hesitancy than consultation with pediatricians or nurses. Moreover, a systematic review found that SCAM use tended to be positively associated with lower childhood immunization. Similar findings were reported also from the US and Australia.

There are several potential causes for the observed relationship between vaccine hesitancy and SCAM. Since SCAM use occurs more frequently at the poles of the disease spectrum (i.e., in cases of minor or life-threatening illness), SCAM use has been identified as a marker of both misperception of risk and frustration with regular healthcare (e.g., negative prognosis or lack of remission of symptoms). Accordingly, SCAM-related health conceptions could be motivating healthcare practitioners (HCPs) to be more reluctant to recommend and receive vaccinations both for illnesses that are perceived as minor and in cases of severe clinical pictures. There are also reasons related to the potential alignment between SCAM and the ideology or worldview of the HCP, such as their distrust in “Big Pharma” or a general disregard for scientific knowledge. Along the same lines, it has been shown that the main reasons for their preference for SCAM included a greater affinity between SCAM, their do-it-yourself approach to health care, and their sympathy for natural and allegedly harm-free products in contrast to medications marketed by pharmaceutical companies, which were perceived as ineffective, “toxic” and “adulterating.”

Besides these implicit reasons, some SCAM traditions are theoretically incompatible with vaccination and portrayed as a valid, or even superior, alternative to scientific knowledge. A quantitative study found that pro-SCAM and anti-vaccination attitudes both reflect beliefs contrary to basic scientific knowledge, such as “an imbalance between energy currents lies behind many illnesses” and “an illness should be treated with a medicine that has properties similar to those of the illness.” An example of these SCAM-related beliefs that contradict the theoretical basis of vaccinations is “homeopathic immunization” through so-called “nosodes” – orally administered extreme dilutions of infectious agents. Similarly, Rudolf Steiner and Ryke Geerd Hamer, promoters of anthroposophic medicine and ‘German New Medicine’, respectively, have sown doubts about vaccinations based on their conceptions of the etiology and treatment of diseases. Consequently, strong science denial and vaccine hesitancy can be found within these communities, and outbreaks of vaccine-preventable diseases, such as measles and whooping cough, have been reported in educational centers linked to anthroposophy.

PS

This project has received funding from the European Union’s Horizon 2020 research and innovation programme.

We have repeatedly discussed the fact that so-called alternative medicine (SCAM) is related to magical health and pseudoscientific assumptions. Now new evidence has emerged on this subject. This study (Alternative Medicine, COVID-19 Conspiracies, and Other Health-Related Unfounded Beliefs: The Role of Scientific Literacy, Analytical Thinking, and Importance of Epistemic Rationality | Studia Psychologica (savba.sk)) examined how scientific literacy (scientific reasoning, scientific knowledge, and trust in science), analytical thinking and the importance of epistemic rationality relate to the belief in the efficacy of so-called alternative medicine (SCAM) and other health-related unfounded beliefs (COVID-19 conspiracies, pseudoscientific and magical beliefs, and cancer myths).

A representative sample of 1038 Slovaks (age = 42.08, SD = 13.99) participated in the study. While SCAM belief correlated with COVID-19 conspiracy theories, pseudoscientific beliefs, magical health-related beliefs, and cancer myths, it appeared that belief in SCAM was primarily driven by lower trust in science, lower analytical thinking, and, interestingly, a higher need to be epistemically rational. Other components of scientific literacy did not significantly predict SCAM belief but they did predict other health-related unfounded beliefs, which may suggest that a more fine-tuned approach to studying SCAM beliefs is needed.

The authors commented that SCAM is moderately related to magical health beliefs and pseudoscientific beliefs and only weakly related to COVID-19 conspiracy theories. However, the weak association between SCAM and conspiracy beliefs is in line with previous findings (Mijatović et al., 2022; Vujić et al., 2022). Similar to previous studies (Fasce & Picó, 2019; Lobato et al., 2014), we found that different unfounded beliefs tend to correlate with each other. However, it appears that COVID-19 conspiracy beliefs are distinct from magical and pseudoscientific beliefs (as evidenced by weaker correlations), whereas SCAM beliefs overlap more with magical health and pseudoscientific beliefs. SCAM beliefs correlated positively with all types of unfounded beliefs, from low to moderate levels (r values between -.16 and -.50) but did not have the same predictors. Contrary to previous findings about the stronger predictive power of scientific reasoning compared to analytical thinking in unfounded beliefs (Čavojová et al., 2020; 2022), our results point to more balanced strengths, except for belief in SCAM, which was not predicted by scientific reasoning. One of the possible explanations lies in the very low reliability of the Scientific Reasoning Scale in this study. On the other hand, other studies using the same scale showed only slightly higher reliability (e.g., Bašnáková et al., 2021, Čavojová et al., 2020; 2023; Čavojová & Ersoy, 2020) and it predicted both COVID-19 conspiracy theories, as well as pseudoscientific/magical component, similarly to the results of previous studies.

This study evaluated the effect of ear acupressure (auriculotherapy) on the weight-gaining pattern of overweight women during pregnancy. It was a single-blinded randomized clinical trial conducted between January and September 2022 and took place in health centers of Qom University of Medical Sciences in Iran.

One-hundred thirty overweight pregnant women were selected by a purposeful sampling method and then divided into two groups by block randomization method. In the intervention group, two seeds were placed in the left ear on the metabolism and stomach points, while two seeds were placed in the right ear on the mouth and appetite points. Participants in the intervention group were instructed to press the seeds six times a day, 20 minutes before a meal for five weeks. For the placebo group, the Vaccaria seedless label was placed at the same points as the intervention group.

A digital scale with an accuracy of 0.1 kg was used to weigh the pregnant women during each visit. Descriptive statistics, independent T-test, chi-square, and repeated measure ANOVA (analysis of variance) test were used to check the research objectives.

There was a statistically significant difference between the auriculotherapy and placebo groups immediately after completing the study (1120.68 ± 425.83 vs. 2704.09 ± 344.96 (g);  = 0.018), respectively. Also, there was a substantial difference in the weight gain of women two weeks (793.10 ± 278.38 vs. 1090.32 ± 330.31 (g);  < 0.001) and four weeks after the intervention (729.31 ± 241.52 vs. 964.51 ± 348.35 (g);  < 0.001) between the auriculotherapy and placebo groups.

The authors concluded that the results of the present study indicated the effectiveness of auriculotherapy in controlling the weight gain of overweight pregnant women. This treatment could be used as a safe method, with easy access, and low cost in low-risk pregnancies. 

In order to understand these findings, it is worth reading the methods section of the paper. It explains what actually happened with the two groups:

After providing explanations to familiarize the participants with the working method and answering their questions, the participants were requested to be comfortable. The first author who has an auriculotherapy certificate did the intervention. The intervention began by disinfecting both ears with a 70% alcohol solution. After determining the location of metabolism and stomach points in the left ear and mouth and appetite points in the right ear related to weight and appetite control, the researcher placed the seeds on the desired points… The intervention lasted for a total of 5 weeks. The seeds were changed twice a week (once every three days) by the researcher. The participants in the intervention group were taught to press the seeds 6 times a day for one minute each time. The pressure method was to use moderate stimulation with continuous pressure. In the first session, the researcher fully taught the participants the amount of pressure and the duration of it in a practical way and asked them to do this once in her presence to ensure that it was correct. Participants were recommended to do this preferably 20 minutes before eating. The researcher reminded the participants in the intervention group of their daily interventions by phone or text message. Each night, they were asked to check if they had followed the instructions and completed the daily registration checklist. In each seed replacement session, which was performed every three days, the checklist of the previous session was viewed and checked, and a checklist was received every week at the same time as the participants were weighed. Subjects were also emphasized in case of any symptoms of allergies or infections and pain as soon as possible through the contact number provided to them to discuss the issue with the researcher to remove the seeds.

In the placebo group, instead of real seeds, a label without Vaccaria seed (waterproof fabric adhesive) was placed by the researcher at the desired points in both ears, and the participants did not receive training to compress the points. They also did not receive the list of daily pressing points. All follow-ups and replacement of labels were performed in the same way as the intervention group in the placebo group. Finally, all participants were requested to notify the researcher if any seeds or labels were removed for any reason. It should be noted that pregnant mothers were unaware of the nature of the group to which they belonged.

It seems clear, therefore, that the patients were NOT blinded and that the verum patients received different care and more attention/encouragement than the placebo group. This means firstly that the trial was NOT single-blind, as the authors claim. Secondly, it means that the outcomes were most likely NOT due to ear acupressure at all – they were caused by the non-specific effects of expectation, extra attention, etc. which, in turn, motivated the women to better control their weight. Consequently, the conclusions of this study should be re-phrased:

The results of the present study fail to indicate the effectiveness of auriculotherapy in controlling the weight gain of overweight pregnant women.

In addition, I feel that the researchers, supervisors, peer-reviewers, editors should all bow their heads in shame for trying to mislead us.

Scientists Katalin Karikó and Drew Weissman, from Hungary and the United States respectively, have received the 2023 Nobel Prize in Physiology or Medicine for discoveries enabling the development of mRNA COVID-19 vaccines.

“The 2023 Nobel Prize in Physiology or Medicine has been awarded to Katalin Karikó and Drew Weissman for their discoveries concerning nucleoside base modifications that enabled the development of effective mRNA vaccines against COVID-19,” the body said. “The laureates contributed to the unprecedented rate of vaccine development during one of the greatest threats to human health in modern times.”

Dr Karikó was senior vice-president and head of RNA protein replacement at BioNTech until 2022, and has since acted as an adviser to the company. She is also a professor at the University of Szeged in Hungary, and adjunct professor at the University of Pennsylvania’s Perelman School of Medicine. Dr Weissman is professor in vaccine research at the Perelman School.

Dr Karikó invented a way to prevent the immune system from launching an inflammatory reaction against lab-made mRNA, previously seen as a major hurdle against any therapeutic use of mRNA. Together with Dr Weissman, she showed in 2005 that adjustments to nucleosides  can keep the mRNA under the immune system’s radar.

The Journal ‘Nature’ reported the following:

This year’s Nobel Prize in Physiology or Medicine has been awarded to biochemist Katalin Karikó and immunologist Drew Weissman for discoveries that enabled the development of mRNA vaccines against COVID-19. The vaccines have been administered more than 13 billion times, saved millions of lives and prevented severe COVID-19 in millions of people, said the Nobel committee…

Karikó is the 13th female scientist to win a Nobel Prize in medicine or physiology. She was born in Hungary and later moved to the United States in the 1980s. “Hopefully, this prize will inspire women and immigrants and all of the young ones to persevere and be resilient. That’s what I hope,” she says.

The COVID-19 vaccines developed by Moderna and the Pfizer–BioNTech collaboration deliver mRNA that instructs cells to create SARS-CoV-2’s spike protein, which, in turn, stimulates the body to make antibodies.

“The ideas that she and Drew Weismann developed were critical for the success of RNA vaccines,” said John Tregoning, a vaccine immunologist at Imperial College London, in a press statement for the UK Science Media Centre. “They demonstrated that changing the type of the RNA nucleotides within the vaccine altered the way in which cells see it. This increased the amount of vaccine protein made following the injection of the RNA, effectively increasing the efficiency of the vaccination: more response for less RNA.”

“This discovery has opened a new chapter for medicine,” said Nobel committee member Qiang Pan-Hammarström, an immunologist at the Karolinska Institute in Stockholm, at a press conference following the prize announcement. “Investment in long-term basic research is very important.”

“It’s really like a revolution starting since the COVID pandemic,” says Rein Verbeke, an mRNA vaccine researcher at the University of Ghent in Belgium. He adds that Karikó and Weissman’s contributions were essential to the vaccines’ success during the pandemic, and beyond. “Their part was really crucial to the development of this platform.” …

The development of mRNA vaccines and therapeutics is in its infancy, says Robin Shattock, who studies vaccines, infections and immunity at Imperial College London. Scientists and biotechnology companies are busy coming up with new applications for mRNA technology, from cancer treatments to next-generation COVID-19 vaccines. Many teams are also working on improved ways of delivering mRNA. “What we see used today is not what it’s going to be used in the future,” says Shattock. “We’re at the beginning of an RNA revolution. The technology is really taking off.”

___________________________

On this blog, we had an abundance of discussions about mRNA vaccines. I wonder whether the anti-vaxx brigade will now consider their position. More likely, however, they will merely claim that the Nobel committe is just another element in the big conspiracy that is about to kill us all.

This sudy made me speachless. I best show the abstract in its full and unadulterated beauty:

Background

Studies have shown homoeopathy to effectively control blood sugar levels and improve quality of life (QOL), though a standard treatment protocol is required.

Objective

This study intended to assess the homoeopathic practice, prescription habits, experience, and perception of Indian Homeopathic Practitioners (HPs) in treating DM.

Methodology

A web-based cross-sectional with a snowball sampling method was conducted between 30th July 2021 and 18th August 2021. A questionnaire to record clinical attributes of Indian HPs in the management of DM was formed after the consensus of the subject experts and pilot testing for feasibility.

Results

Participants were 513 HPs with mean age [Standard Deviation (SD)] of 40.44 years (11.16) and a mean duration of the homoeopathic medical practice of 14.67 years [95% Confidence Interval (CI) = 13.71–15.63]. The majority of HPs made classical homoeopathic prescription (201, 39.2%) though the success in the management of DM was better among HPs who prescribed more than one potentized medicine [vs classical prescription, Odds Ratio (OR) = 2.34, p = 0.032]. As perceived by the HPs, homoeopathic treatment resulted in a major improvement in QOL of the diabetic patients (418, 81.5%) with very few adverse effect (100, 19.5%). The blood sugar level was controlled better when homoeopathy was given alongside conventional medicine (348, 67.8%).

Conclusion

The clinical experience of HPs in this study has shown that homoeopathic treatment can benefit DM patients in preventing complications and improving QOL. It further reported that homoeopathy can be an important adjuvant to conventional treatment in managing DM.

Let’s be clear: there is no reliable evidence that DM – a life-threatening disease –  can be effectively treated with homeopathy. And let’s be blunt: HPs who claim otherwise are in my view criminal.

I should mention that some of the patients had type 1 diabetes. Many HPs felt that “there was a lack of awareness about the effectiveness of homoeopathy in DM among the general population”. The data show that in 7% the HPs discontinued conventional ant-diabetic drugs completely, and in 73% they reduced them.

It seems that the general population is well advised to ignore homeopathy and its alleged effectiveness for DM. I would even go one step further and postulate that:

if patients rely on homeopathy to treat their diabetes, they risk their lives!

The COVID-19 pandemic has been notable for the widespread dissemination of misinformation regarding the virus and appropriate treatment. The  objective of this study was to quantify the prevalence of non–evidence-based treatment for COVID-19 in the US and the association between such treatment and endorsement of misinformation as well as lack of trust in physicians and scientists.

This single-wave, population-based, nonprobability internet survey study was conducted between December 22, 2022, and January 16, 2023, in US residents 18 years or older who reported prior COVID-19 infection.

Self-reported use of ivermectin or hydroxychloroquine, endorsing false statements related to COVID-19 vaccination, self-reported trust in various institutions, conspiratorial thinking measured by the American Conspiracy Thinking Scale, and news sources.

A total of 13 438 individuals (mean [SD] age, 42.7 [16.1] years; 9150 [68.1%] female and 4288 [31.9%] male) who reported prior COVID-19 infection were included in this study. In this cohort, 799 (5.9%) reported prior use of hydroxychloroquine (527 [3.9%]) or ivermectin (440 [3.3%]). In regression models including sociodemographic features as well as political affiliation, those who endorsed at least 1 item of COVID-19 vaccine misinformation were more likely to receive non–evidence-based medication (adjusted odds ratio [OR], 2.86; 95% CI, 2.28-3.58). Those reporting trust in physicians and hospitals (adjusted OR, 0.74; 95% CI, 0.56-0.98) and in scientists (adjusted OR, 0.63; 95% CI, 0.51-0.79) were less likely to receive non–evidence-based medication. Respondents reporting trust in social media (adjusted OR, 2.39; 95% CI, 2.00-2.87) and in Donald Trump (adjusted OR, 2.97; 95% CI, 2.34-3.78) were more likely to have taken non–evidence-based medication. Individuals with greater scores on the American Conspiracy Thinking Scale were more likely to have received non–evidence-based medications (unadjusted OR, 1.09; 95% CI, 1.06-1.11; adjusted OR, 1.10; 95% CI, 1.07-1.13).

The authors concluded that, in this survey study of US adults, endorsement of misinformation about the COVID-19 pandemic, lack of trust in physicians or scientists, conspiracy-mindedness, and the nature of news sources were associated with receiving non–evidence-based treatment for COVID-19. These results suggest that the potential harms of misinformation may extend to the use of ineffective and potentially toxic treatments in addition to avoidance of health-promoting behaviors.

This study made me wonder to what extend a lack of trust in physicians or scientists, and conspiracy-mindedness are also linked to the use of so-called alternative medicine (SCAM) for treatning COVID infections. As I have often discussed, such associations have been reported regularly, e.g.:

The authors point out that the endorsement of misinformation related to COVID-19 has been shown to decrease the intention to vaccinate against COVID-19, to decrease the belief that it is required for herd immunity, and to correlate with forgoing various COVID-19 prevention behaviors. Such false information is largely spread online and often originates as disinformation intentionally spread by political actors and media sources, as well as illicit actors who profit from touting supposed cures for COVID-19.  A substantial minority of the public endorses false information related to COVID-19, although certain subgroups are more likely to do so, including those who are more religious, who distrust scientists, and who hold stronger political affiliations. Cultivating and maintaining trust is a crucial factor in encouraging the public to engage in prosocial health behaviors. The extent to which addressing conspiratorial thinking could represent a strategy to address obstacles to public health merits further investigation.

The Skeptic reported that a cardiologist and one of the UK’s most influential critics of the COVID-19 vaccine, Dr Aseem Malhotra, has been named the 2023 recipient of the “Rusty Razor” award, the prize given by The Skeptic to the year’s worst promoters of pseudoscience.

Dr Malhotra has made a name for himself over the last decade as a cardiologist who advocates strongly against the broad use of statins. He has described the drugs as a multi-billion dollar “con” by the pharmaceutical industry, saying that his critics have “received millions in research funding from the pharmaceutical industry”. He has described the link between heart disease and saturated fat as a “myth”, drawing criticism from the British Heart Foundation.

In 2017, his book The Pioppi Diet put forward a diet that he claimed could prevent 20 million deaths per year from cardiovascular disease. The book was named by the British Dietetic Association as one of the celebrity diets to most avoid – with the BDA highlighting his apparently Mediterranean diet excluded pasta and bread, but included coconuts.

Throughout the COVID-19 pandemic, Dr Malhotra has been a prolific and powerful voice spreading narratives that run contrary to the best available evidence. In 2021, his book The 21-Day Immunity Plan included a diet claimed to improve the immune system and help fight off infections – claims that drew criticism from medical professionals.

In 2022, Dr Malhotra released a paper claiming that COVID-19 mRNA vaccines posed a serious risk to cardiovascular health and that the vaccines were “at best a reckless gamble”. The paper was published in the Journal of Insulin Resistance – where Dr Malhotra sits on the editorial board.

Dr Malhotra and his campaign against the COVID-19 vaccine was subsequently praised in Parliament by Andrew Bridgen MP as part of the reasoning behind his ongoing anti-vaccine crusade. In January of this year, Dr Malhotra used a BBC interview about statins to claim that deaths from coronary artery disease were actually complications from the vaccine, prompting a slew of complaints, and an apology from the broadcaster.

The Skeptic Editor Michael Marshall said: “In our opinion, Dr Malhotra has been an incredibly prolific promoter of pseudoscience throughout the pandemic, including spreading the false notion that vaccines are responsible for thousands of excess deaths.

“Dr Malhotra’s media career has given him a very large platform, from which he spreads misinformation that undermines confidence in a health intervention that has saved the lives of countless people across the world. In doing so, he stokes the flames of conspiracy, paranoia and mistrust of medical consensus.

“For anyone with so large a platform to do this would be concerning enough, but Dr Malhotra shares these pseudoscientific messages as a registered medical professional whose opinions have influenced at least one current member of parliament.

“All of this, we feel, makes Dr Aseem Malhotra a highly deserving winner of the 2023 Rusty Razor award”

The ‘Rusty Razor’ award was announced as part of The Skeptic’s annual Ockham Awards at a ceremony that took place during Saturday’s QED conference on science and skepticism, in Manchester. Also recognised during the event was the Knowledge Fight podcast, who won the 2023 award for Skeptical Activism.

I agree, Malhortra is a deserverd winner. The prize raises, in my view, an important question:

WHAT ON EARTH IS THE GENERAL MEDICIN COUNCIL (GMC) DOING ABOUT THIS GUY?

Malhotra’s activities have been compared to the case of Andrew Wakefield who falsely claimed that the MMR vaccine was linked to autism. While Wakefield was ultimately struck off by the GMC in 2010, the regulator has so far rebuffed repeated pleas to investigate Dr Malhotra.

The BMJ recently reported that Dr. Matt Kneale, who had previously complained to the GMC about the conduct of Aseem Malhotra, was told that the GMC would not be investigating Malhotra because his statements were not sufficiently “egregious” to merit action and he had a right to “freedom of speech.” Kneale’s appeal against this decision in 2023 was also turned down.

Kneale has now filed a claim with the High Court, arguing that the GMC should consider not only whether a doctor’s behaviour could harm individual patients but also whether their actions undermined public trust in medicine. He said that this was particularly important when examining statements relating to vaccines, where doctors with a high profile on social media could potentially cause great harm.

The US ‘Public Citizen‘ is an American non-profit, progressive consumer rights advocacy group, and think tank based in Washington, D.C. They recently published an article entitled “FDA Guidance on Homeopathic Drugs: An Ongoing Public Health Failure“. Here are a few excerpts:

In December 2022, the U.S. Food and Drug Administration (FDA) issued new guidance on homeopathic drug products. The guidance states that the agency now “intends to apply a risk-based enforcement approach to the manufacturing, distribution and marketing of homeopathic drug products.”

Under this new risk-based approach, the agency plans to target its enforcement actions against homeopathic drug products marketed without FDA approval that fall within the following limited categories:

  • products with reports of injury that, after evaluation, raise potential safety concerns
  • products containing or purportedly containing ingredients associated with potentially significant safety concerns (for example, infectious agents or controlled substances)
  • products that are not administered orally or topically (for example, injectable drug products and ophthalmic drug products)
  • products intended to be used to prevent or treat serious or life-threatening diseases
  • products for vulnerable populations, such as immunocompromised individuals, infants and the elderly
  • products with significant quality issues (for example, products that are contaminated with foreign materials or objectionable microorganisms)

But this new FDA guidance fails to adequately address the public health threat posed by the agency’s decades-long permissive approach to these illegal drug products.

Under FDA regulations, prescription and over-the-counter (OTC) homeopathic products are considered drugs and are supposed to be subject to the same review and approval requirements as all other prescription and OTC medications. However, under a flawed enforcement policy issued in 1988, the FDA has allowed these drug products to be marketed in the U.S. without agency review or approval. Thus, all products labeled as homeopathic are being marketed without the FDA having evaluated their safety, effectiveness or quality…

… there is no plausible physiologic or medical basis to support the theory underlying homeopathy, nor is there evidence from well-designed, rigorous clinical trials showing that homeopathic drugs are safe and effective.

The FDA should declare unequivocally that all unapproved homeopathic drug products are illegal and direct all manufacturers to immediately remove such products from the market. In the meantime, as we have recommended for many years, consumers should not use homeopathic products. At best, the products are a waste of money, given the lack of any evidence that they are effective. At worst, they could cause serious harm because of the lack of FDA oversight to ensure safety.

_____________________

I fully agree with these sentiments. The harm caused by homeopathy is considerable and multi-facetted. Many previous posts have discudded these problems, e.g.:

Having warned about the dangers of homeopathy for decades, I feel it is high time for regulators across the world to take appropriate action.

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