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

pseudo-science

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.

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.

 

These are exceptional times and they need exceptional measures. Therefore, I am yet again deviating from my policy of focussing exclusively on SCAM and welcome my French colleague Dr Lehmann posting a series of articles on the hydroxychloroquine story.

Guest post by Christian Lehmann

 

THE ELEPHANT IN THE ROOM

This pandemic diary was begun just before lock down, already four weeks ago, and yet I have scarcely touched on the elephant in the room. Our personal elephant is called Didier Raoult. White-haired with age, venerable in appearance, he has been number one in the press, constantly in capitals in online news headlines, waking hopes, feeding passions. And arousing the interest of a plethora of epidemiologists of renown, from Valerie Boyer to Donald Trump, by way of Alain Soral and Alexandre Benalla.

Everything begins on 25 February 2020, when the microbiology professor from Marseille posts his famous video “Coronavirus, game over”, since more modestly re-baptised “Coronavirus, towards a way out of the crisis?”.

Standing in front of a student audience out of camera, Didier Raoult reveals “a last-minute scoop, a very important piece of news”: the Chinese, whom he regularly advises, rather than seeking a vaccine or new products have been “repositioning”, trying old molecules, “known, old, without toxicity,” among them chloroquine, which has shown itself to be effective in a daily dose of 500 mg per day “with a spectacular improvement and it is recommended for all clinically positive cases of coronavirus. This is excellent news, it is probably the easiest respiratory infection of all to treat” Here, the whole roomful laughs, with pleasure, with relief, and I remember sharing these sentiments, briefly, but completely. Because this was 26th of February, because like others I felt confusedly that the reassurances with which Agnes Buzyn ( then the French Health Minister) was inundating us were built on sand, and that the virus would only laugh at little notices in airports.

I knew Didier Raoult only by name, as a columnist in Point, I had read some of his articles and I had felt simultaneously soothed by his smooth eloquence, attracted by some of his iconoclastic stances, but also sometimes rather irritated by his Mandarin-style fake cool posturing. At the end of February, I immediately reposted the video in the medical forums, on the walls of worried friends, explaining that, if the suggestions of Didier Raoult were confirmed, we would have escaped with a scare which would soon be dispelled by this “magic bullet”, this “game changer”.

Then between two consultations in my GP’s office, later that afternoon, I watched that video “Game Over” again. How could such an important piece of news have reached me by means of a Youtube video? Where were the overseas publications, the much vaunted Chinese study, the releases from AgenceFrancePresse, Reuters, the first articles from the New York Times and the Guardian, proclaiming from the rooftops that the pandemic we had so much feared was in fact only a technical hitch, easily controllable by a widely available drug. It was at that second viewing that I balked. As a GP who had worked in cardiac resuscitation some years ago, I was brought up short by hearing Didier Raoult talking up a medicine “well known, and devoid of any toxicity”. If chloroquine or Nivaquine, to give it its commercial name, is celebrated for the prevention of malaria, it is also a medicine known for its frightening toxicity as soon as the dose is exceeded, with the risk of irreversible visual damage and extremely serious problems with cardiac rhythm which can prove fatal. To say that chloroquine is without toxicity problems is in fact an error, all the more so because the dose suggested by “the Chinese”, without an iota of proof at this stage, is five times larger than the customary dose, 500 mg instead of 100 mg.

Deeply uneasy, I’m in discussion with doctor friends on Twitter when the video makes its appearance there. We know nothing at this point about Didier Raoult’s past, or about his Marseille Institute. Neither the enmity felt towards him by the Parisian intelligentsia represented by Agnes Buzyn and her husband, nor the fact that his institute has just lost its INSERM and CNRS accreditations, nor the stance adopted by him a month earlier explaining that coronavirus would never escape from China and that it was ridiculous to get worked up about it because “the world has gone mad, something or other happens and three Chinese die and that brings about a world-scale alert”.

Some of us, practitioners and first responders, knew well the toxicity of chloroquine, that it was to be handled with care, and that was about all we said on Twitter. It was already too much. The next day in a 20 minute interview Didier Raoult brushed away his detractors. “Malicious gossip, I don’t give a damn about it. When a medication has been shown to work on 100 people while all the world is busy having a nervous breakdown, and there’s some idiots who say there’s no certainty that it works, I’m not interested! It would honestly be medical misconduct not to use chloroquine to treat Chinese coronavirus”. And he drives the point home. “People who have lived in Africa like me took chloroquine every day. Everybody who went to hot countries took it throughout their time there, and for two months after they came home. Billions of people have taken this medication. And it costs nothing: ten centimes per pill. It is a medication which is extremely reliable and it’s the cheapest imaginable. So this is super amazing news. Everybody who learns about these benefits should fall upon it.” This is no longer a mistake, this is grave medical misconduct. Nobody who knows about therapeutics would use such words so lightly.

Cardiologists, resuscitation specialists, emergency doctors, GPs, public-health specialists, we are all alarmed. Our first warnings are vehement and rational, reaffirming the toxicity of chloroquine in cardiology, and the majority of us insisting on the senseless and significant risk which Didier Raoult is running. Because it is familiar, prescribed for long stays in Africa in packages of 100 tablets, chloroquine is lying around in many medicine cabinets. To declare as a fact that we should “fall upon it” in this agonising pandemic context is to encourage unrestrained self medication, and to endanger life. Incoherent, dangerous, this announcement disturbs us deeply. Incredulous, not for a moment do we imagine just what Didier Raoult will unleash, nor that the nightmare had already begun.

 

Referring to possible treatments for corona-virus infections during a press-conference, Trump said the following:

“So supposing we hit the body with a tremendous—whether it’s ultraviolet or just a very powerful light—and I think you said that hasn’t been checked because of the testing…And then I said, supposing you brought the light inside the body, which you can do either through the skin or some other way.”

We already suspected that Trump has a thing about UV light.

We also knew that Trump has links to the SCAM scene. And his recent outburst sounds as though the president has come across a particular SCAM called ‘Ultraviolet Blood Irradiation’.

“Ultraviolet Blood Irradiation” (UBI), also called “ BioPhotonic Therapy”, is a treatment that was popular with German naturopaths a few decades ago. It seems to experience a revival and is bound to boom, now that Trump has claimed that UV light in the body might be effective against the corona-virus.

I have conducted in-vitro experiments with this method in the mid 1980s (sorry, I cannot find the publication and am not even sure we ever published the results). They failed to show any meaningful effects on blood rheology which was my main research interest at the time. I thus know how the method works:

  1. You draw a small (10-30 ml) venous blood sample.
  2. You anticoagulate it.
  3. You place it in a special chamber.
  4. You radiate it for a prescribed time with UV light.
  5. You inject the blood back into the patient.

There are semi-automated devices that are commercially available and render the process fairly easy. It seems that UBI has become popular in the US SCAM scene. One advocate of UBI informs us that:

This proven therapy has 70 years of history, helping those who still suffer after exploring other medicines.  Step into the world of over 140 published medical studies where BioPhotonic Therapy has shown amazing success rates.

  • No major side effects
  • Treats over 40 diseases  
  • Low cost 
  • Helps those in need

The same advocate also lists several viral infections for which UBI is, in his opinion, effective:

  • Hepatitis
  • HIV
  • Influenza
  • Herpes simplex/zoster
  • Mononucleosis
  • Mumps
  • Measles Infections
  • Viral Pneumonia
  • Polio

A more modern version of the same method has recently received CE marking to commercially sell its UVLrx 1500 multi-wavelength, intravenous light therapy system in the European Union. The UVLrx 1500 System offers the first intravenous, concurrent delivery of ultraviolet-A (UVA) and multiple visible light wavelengths. Using the company’s patent pending Dry Light Adapter™ and a standard I.V. catheter, the UVLrx 1500 eliminates the need for removal of blood from the body.

UVLrx’s CE marking covers the following indications:

  • Reduction of pain
  • Reduction of pathogens in the blood
  • Reduction of inflammation
  • Immune system modulation
  • Improved ATP synthesis
  • Improved wound healing
  • Improved blood oxygen transport
  • Improved circulation

Needless to say, I think, that there is no good evidence for any of these claims. Yes, there are quite a few papers on UBI and related methods. But most of them are in-vitro studies, while robust clinical trials are missing completely (if someone knows otherwise, I’d be pleased to correct this statement). Needless to say also that UBI is an invasive treatment where lots of things might go badly wrong.

So why is Trump promoting this UV therapy idea?

Search me!

The UK university at Teesside has announced its plan to offer a chiropractic degree. The course will be hosted by its School of Health and Life Sciences and the Department of Allied Health Professions. The designated course leader, Daniel Moore, explains:

“The benefit for us when we developed this curriculum from a blank canvas was not only exciting, but it granted an opportunity for us to do things in a slightly different way.  The placement model is something I feel we may see more of in the future because the benefit it gives students is significant from a confidence point of view, and provides interaction with both the profession and patients from the first semester.  We also could create our modules from scratch giving us the ability to build context into historically quite fixed modular content whilst staying mapped to the education standards.  We also give all students iPads from the start of their degree which will allow us to collaborate and communicate in a really unique and beneficial way throughout the course.”

“I have always been interested in knowledge transfer, and how as individuals we learn and how we develop ourselves.  Part of my draw to being a chiropractor was my wanting to help people become the best version of themselves.  So it isn’t a great leap to the higher educational world where my goal now is similar, facilitating and leading people towards being the best chiropractor they can be.  They can then move into the profession and make a positive impact themselves.  I feel I can make a positive difference to the profession here, and that is important to me.”

“My goal in my mind is clear.  To create chiropractors that are safe, competent and confident, to go into practice and add value to the chiropractic profession.  I also hope I can create students that are excited to graduate and practice chiropractic, I feel we have a lot to offer as chiropractors and students should be excited about that opportunity.”

“I am from the North East of England, so have an affinity to this region.  I am passionate about chiropractic and think my history, since being a student shows my willingness to represent that.  I was a student member of the NMSK faculty of the College of Medicine as well as being on WIOC Student Council for 4 years.  I then moved into practice where I took on delivery of CPD events for the RCC, qualified as an FA Medical Tutor, I was also involved in writing initial material for the RCC’s online Quality Standards offering, and have been involved in multiple British Masters Athletics Medical Team events with a great group of people over the years.  I am a dad, to two wonderful boys and a husband to Elaine (also a chiropractor and BCA member).  I keep myself fit, and race Cross Country Mountain Bikes and Cyclocross to a national level and plan on competing at the World Masters Championships this August all things being well. Now I lead the chiropractic course at Teesside and I am planning my PhD, I couldn’t be more excited about the opportunities that lay ahead.”

Allow me to add a few points and ask a few questions:

  1. Mr Moore wants to ‘create chiropractors that are safe, competent and confident’. How about creating therapists who are effective in curing or alleviating disease or symptoms? Has he perhaps realised that, in chiropractic, this is not possible? Do his peers at Teesside know that chiropractic does not generate more good than harm?
  2. I am fascinated to learn that Mr Moore is now planning to do his PhD. Should a higher degree not have been a precondition to becoming a course leader in academia?
  3. As far as I can see, Mr Moore has never published a single paper in the peer-reviewed literature. Should a track record in research not have been a precondition to becoming a course leader in academia?
  4. Does the University of Teesside know that even the most proper (and I fear the course does not even appear to be proper) teaching of nonsense must result in nonsense?
  5. Have they taken leave of their senses at Teesside university?

Yes, you read this correctly: 2/3 of the German population revealed themselves to be stupid – at least this is what a survey sponsored by the German Association of Homeopathic Doctors seems to imply.

Hard to believe?

Well, read the press-release for yourself [and if you are not reading German, let me fill you in below]:

Fast zwei Drittel der Bevölkerung in Deutschland würde den Einsatz homöopathischer Arzneimittel zur Behandlung von Covid-19-Erkrankungen befürworten.

Das ist eines von mehreren Ergebnissen einer repräsentativen Umfrage des Instituts für Politik- und Sozialforschung forsa, durchgeführt im Auftrag des Deutschen Zentralvereins homöopathischer Ärzte.

Angst vor Covid-19. Interesse an homöopathischen Methoden.

Befragt wurden insgesamt 1009 Bundesbürger, unter anderem zum Grad ihrer Besorgnis vor einer Erkrankung an Covid-19, ihrem Interesse an Vorsorgemaßnahmen gegen eine Corona-Infektion zusätzlich zu besonderer Hygiene, ihrer Einstellung zu einer Behandlung von Covid-19 mit homöopathischen Arzneimitteln, sowie zur Befürwortung oder Ablehnung staatlicher finanzieller Förderung von Forschungsprojekten zu homöopathischen Vorsorge- und Behandlungsmethoden von Covid-19-Erkrankungen.

61% ziehen homöopathische Behandlung mindestens ernsthaft in Betracht

Mehr als die Hälfte aller Befragten hat bereits Erfahrung mit einer homöopathischen Behandlung bei früheren Erkrankungen gemacht. Noch mehr, nämlich fast zwei Drittel aller Befragten, würden unter der Voraussetzung, dass es in der Vergangenheit schon positive Erfahrungen mit diesem Mittel gab, im Fall einer Erkrankung an Covid-19 eine homöopathische Behandlung für sich selbst oder ihnen nahestehenden Personen auf jeden Fall (26 %) oder eher (34 %) befürworten

Homöopathie soll auch Gelder für Forschungsprojekte erhalten

Auch hinsichtlich der weiteren Erforschung von Methoden zur Vorbeugung gegen eine Infektion mit dem Corona-Virus und der Behandlung von Covid-19 fänden es viele Bürger (42 %) in Deutschland gut oder sehr gut- in der Altersgruppe über 45 Jahren sogar rund oder mehr als die Hälfte – dass staatliche Gelder nicht nur in Forschungsprojekte der konventionellen Medizin gesteckt werden, sondern dass auch Projekte der homöopathischen Medizin gezielt gefördert werden.

Here is the gist of the press-release for non-German speakers:

The German Association of Homeopathic Doctors paid an otherwise respectable agency to run a poll for them; not just any poll, but one that is robust enough to be representative of the entire German population (sample size of 1009!). The questions asked were about homeopathy in the present health crisis. The results show that:

  • 61% would seriously consider using homeopathy,
  • more than 50% have had positive experience with homeopathy during previous episodes of illness,
  • more than 2/3 would consider homeopathy for a corona-virus infection, provided that there has been positive experience with this approach in the past,
  • 42% of Germans would find it good or very good, if public funds would also be dedicated to research in homeopathy.

What does that tell us?

It tells us that the Germans are not that stupid after all: they would only consider homeopathy for a corona-virus infection, if there has been positive experience with this approach in the past. As such positive evidence is absent, they would not consider homeopathy!

The poll also tells us that surveys can be spun to generate the most idiotic findings provided the questions that are being asked are phrased in a sufficiently leading way. It moreover tells us that the German Association of Homeopathic Doctors seem to believe that Germans are stupid and do not realise that this survey is a despicable stunt for boosting their failing business. Finally, it tells us that the German Association of Homeopathic Doctors are behaving grossly unethical to promote homeopathy during this pandemic. There is not a jot of evidence that homeopathy might be effective and a lot of evidence to show that promoting useless treatments is dangerous.

Many experts are wondering whether it is possible to stimulate our immune system such that we are better protected against getting infected with the coronavirus. Several options have been considered.

An innovative approach, for instance, seems to be this one:

Recently, we showed that intravenous immunoglobulin (IVIg) treatment reduces inflammation of intestinal epithelial cells and eliminates overgrowth of the opportunistic human fungal pathogen Candida albicans in the murine gut. Immunotherapy with IVIg could be employed to neutralize COVID-19. However, the efficacy of IVIg would be better if the immune IgG antibodies were collected from patients who have recovered from COVID-19 in the same city, or the surrounding area, in order to increase the chance of neutralizing the virus. These immune IgG antibodies will be specific against COVID-19 by boosting the immune response in newly infected patients. Different procedures may be used to remove or inactivate any possible pathogens from the plasma of recovered coronavirus patient derived immune IgG, including solvent/detergent, 60 °C heat-treatment, and nanofiltration. Overall, immunotherapy with immune IgG antibodies combined with antiviral drugs may be an alternative treatment against COVID-19 until stronger options such as vaccines are available.

Another suggestion involves monoclonal antibodies:

The therapeutic potential of monoclonal antibodies has been well recognized in the treatment of many diseases. Here, we summarize the potential monoclonal antibody based therapeutic intervention for COVID-19 by considering the existing knowledge on the neutralizing monoclonal antibodies against similar coronaviruses SARS-CoV and MERS-CoV. Further research on COVID-19 pathogenesis could identify appropriate therapeutic targets to develop specific anti-virals against this newly emerging pathogen.

These and several further options have in common that they are not backed by robust clinical evidence. Such a lack of data rarely bothers charlatans who use the corona-panic for promoting their bizarre concepts. Numerous promoters of so-called alternative medicine (SCAM) are trying their very best to mislead the public into thinking that their particular SCAM will do the trick.

In comes the PYROMANIAC IN A FIELD OF (INTEGRATIVE) STRAW-MEN, Dr Michael Dixon who recently proclaimed that ‘boosting immunity against coronavirus: ‘Now’s the time to turn to antioxidants and polyphenols’. Specifically, he recommended:

‘Eat dark greens, broccoli, spinach or any coloured root vegetable such as beetroot or carrots and any fruit ending in the word berry; black, blue… The alliums, such as leeks and garlic and onions, are very strong in the same sort of chemicals and also even things like dark chocolate and certain teas, particularly green tea. Those who want a glass of red wine, well that’s something that’s very much permitted too.’

Inspired by such positive thinking, I ventured to find some evidence for Dixon’s infinite wisdom. It could be that I am not very gifted at locating evidence – or perhaps there isn’t any?

Well, not quite; there is some on garlic that Dixon praises for its immune-boosting activity. Here is the abstract of a Cochrane review:

Background

Garlic is alleged to have antimicrobial and antiviral properties that relieve the common cold, among other beneficial effects. There is widespread usage of garlic supplements. The common cold is associated with significant morbidity and economic consequences. On average, children have six to eight colds per year and adults have two to four.

Objectives

To determine whether garlic (Allium sativum) is effective for the prevention or treatment of the common cold, when compared to placebo, no treatment or other treatments.

Search methods

We searched CENTRAL (2014, Issue 7),OLDMEDLINE (1950 to 1965),MEDLINE (January 1966 to July week 5, 2014), EMBASE(1974 to August 2014) and AMED (1985 to August 2014).

Selection criteria

Randomised controlled trials of common cold prevention and treatment comparing garlic with placebo, no treatment or standard treatment.

Data collection and analysis

Two review authors independently reviewed and selected trials from searches, assessed and rated study quality and extracted relevant data.

Main results

In this updated review, we identified eight trials as potentially relevant from our searches. Again, only one trial met the inclusion criteria. This trial randomly assigned 146 participants to either a garlic supplement (with 180 mg of allicin content) or a placebo (once daily)for 12 weeks. The trial reported 24 occurrences of the common cold in the garlic intervention group compared with 65 in the placebo group (P value < 0.001), resulting in fewer days of illness in the garlic group compared with the placebo group (111 versus 366). The number of days to recovery from an occurrence of the common cold was similar in both groups (4.63 versus 5.63). Only one trial met the inclusion criteria, therefore limited conclusions can be drawn. The trial relied on self reported episodes of the common cold but was of reasonable quality in terms of randomisation and allocation concealment. Adverse effects included rash and odour.

Authors’ conclusions

There is insufficient clinical trial evidence regarding the effects of garlic in preventing or treating the common cold. A single trial suggested that garlic may prevent occurrences of the common cold but more studies are needed to validate this finding. Claims of effectiveness appear to rely largely on poor-quality evidence.

Of course, this is not about corona but about the common cold. As for green tea, a recent review found a lack of reliable clinical data demonstrating its immune-boosting activities, a deficit also noted for chocolate.

But where IS the evidence that any of the above claims are true?

Could it be that there is no sound evidence to support Dixon’s recommendations?

Impossible!!!

That would mean that Dixon, advisor to Prince Charles, is stating nonsense in the name of his COLLEGE OF MEDICINE AND INTEGRATED HEALTH. This organisation has many very respectable people as members and officers. They would never allow that sort of thing to happen!

Or would they?

DD Palmer, the founder of chiropractic, famously claimed that 95% of all diseases are caused by subluxations of the spine and the rest by subluxations of other joints. He said and stated this theory in different forms not once but dozens of times, and it thus quickly became the mantra of chiropractic. When it was noted that subluxation, as imagined by Palmer and his son BJ, did not exist, chiropractors found themselves with a considerable amount of egg on their faces.

Ever since, they have tried to cover up the blemish, some by repeatedly re-defining subluxation, others by claiming that they do not believe in Palmer’s theory anyway. The issue was and is fiercely fought over even threatened to break up the profession. At present, we are being told incessantly that large chunks of the profession are reformed, have come to terms with their profession’s foundation in a fictional concept, and have now abandoned subluxation altogether.

Critics, in turn, are quick to point out that, if that is so, chiropractors lack a ‘raison d’être’. The best chiropractors of this persuasion could do, they say, is to re-train as physiotherapists who also use spinal manipulation but without the nonsensical chiropractic ‘philosophy’.

While this debate is ongoing and shows no sign of subsiding, it is relevant, of course, to ask what proportions of the chiropractic profession belongs to which persuasion. This paper evaluated the issue of the professional identity within the profession of chiropractic based on the literature from 2000 to 2019. Initially 562 articles were sourced, of which 24 met the criteria for review.

The review confirmed three previously stated professional identity subgroups:

  • a vitalistic approach pro subluxation,
  • a approach contra subluxation,
  • a centrist or mixed view.

Whilst these three main chiropractic identity sub-types exist, the terminology used to describe them differs. Research aimed at categorising the chiropractic profession identity into exclusive sub-types found that at least 20% of chiropractors have an exclusive vertebral subluxation focus. However, deeper exploration of the literature shows that vertebral subluxation is an important practice consideration for up to 70% of chiropractors.

The review also found that practising chiropractors consider themselves to be primary care or primary contact practitioners with a broad scope of practice across a number of patient groups not limited to musculoskeletal management.

So, if I understand these findings correctly, they confirm that chiropractors like to see themselves as physicians who are able to treat most conditions that present themselves in primary care. At the same time, their majority considers that vertebral subluxation is an important practice consideration. This clearly suggests they are likely to treat most conditions by adjusting spinal subluxations. In turn, this implies that DD Palmer’s dictum, ‘95% of all conditions are caused by subluxations of the spine’, is still adhered to by about 70% of all chiropractors.

If this is so, the best advice I can give to the general public is this: if you have a health problem, the last person you should consult is a chiropractor.

Subscribe via email

Enter your email address to receive notifications of new blog posts by email.

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories