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

risk

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By guest blogger Ken Harvey

Loretta Marron was the catalyst. The ‘critical thinking’ bug hit her as a child, reinforced by a BSc in Physics. If something didn’t sound logical, she couldn’t let it go. She had to check. She killed many a party by disputing misinformation – with evidence.

TV advertisements for magnetic underlays got her going, then homeopathic remedies, followed by ‘natural’ cures for cancer. To investigate outlandish claims and submit complaints, she needed to consult with experts. These included Professors John Dwyer (Medicine and Immunology) and Alastair MacLennan (Obstetrics and Gynaecology). They were always willing to help.

They also had concerns about universities teaching pseudoscience, such as ‘subluxation theory’ in chiropractic and ‘meridians’ in Traditional Chinese Medicine.

In late 2011, Professor Dwyer proposed that Loretta join forces with Professors Alastair MacLennan, Marcello Costa (neuroscientist), and Rob Morrison (science communicator) to form a new organisation promoting scientific evidence in health care. Friends of Science in Medicine (FSM) was born. John Dwyer was the inaugural President and Loretta Marron Chief Executive Officer (CEO).

The aim was to emphasise the importance of basing Australian health care on scientifically sound research and established scientific knowledge published in peer-reviewed journals of accepted standing. Valuing scientific rigour is especially important in an age where unsubstantiated health claims are rampant and scientific consensus is ‘imbalanced’ by the views of extremists.

FSM’s focus is helping consumers and health professionals to make more informed choices about medical interventions, medicines, and medical devices. We do this by submitting complaints about unethical practice, analysing policy, making submissions, encouraging regulators to act, and being a credible source of expertise for the media and others. We also encourage tertiary institutions and medicine and health sciences students to critically appraise therapeutic products and services as part of the courses offered.

Currently, FSM has more than 1,200 leading scientists, clinicians, lawyers, and consumer advocates as supporters. We also work closely with organisations such as Australian Skeptics and Choice (Australian Consumers Association).

I took over as President from John Dwyer in 2019. Loretta remains FSM CEO. The founding members continue their involvement as consultants. Ten years on, it’s worth reflecting on what has been achieved and the ongoing challenges.

An appendix lists some of the areas in which FSM has been involved and the outcomes achieved (often with the help of others).

Unethical promotion of therapeutic goods and services remain an ongoing concern. The advertising of therapeutic goods is subject to provisions in the Therapeutic Goods Advertising Code, first promulgated in 1999. Until July 2018, complaints about alleged Code violations were heard by the Therapeutic Goods Advertising Complaints Resolution Panel (CRP), thereafter by the Therapeutic Goods Administration (TGA).

FSM members submitted numerous complaints to the CRP and analysed the outcome. If a complaint was upheld, the CRP could only ‘recommend’ that it be removed. If it was not, the complaint was referred to the TGA for action. We found that certain companies consistently ignored the determinations of the CRP and, when referred to the TGA, took resulting action.

In July 2018, FSM engagement with numerous consultations and reviews eventually resulted in the TGA taking over the advertising complaint system. The TGA was given stronger investigative and compliance powers and a revised, legally enforceable advertising code. However, given the TGA’s previous track record, we continued to submit complaints, including many previously upheld by the CRP, but for which promotion continued.

An analysis of the first 12 months of the new system found that the TGA had classified most complaints as ‘low priority’. These were either ignored or closed by sending the advertiser a ‘Regulatory Obligation letter’ which stated that no further action would be taken. While the letter sometimes worked, often it did not. Stronger compliance powers were rarely used. The new complaint system was also less transparent than the one it replaced. For those low priority complaints with published outcomes, no details of the product, advertiser, or alleged Code violation were published, and no follow-up was recorded. Of 121 higher priority complaints, 79% failed to meet their key performance indicator, time to closure in 60–90 days. These included complaints about dangerous sports supplements and ineffective weight loss and hangover products.

In August 2020, an independent review of the first two years of the TGA’s compliant system was published. The study noted an unexpectedly high volume of complaints since the TGA took over the advertising complaints system, producing a large and growing backlog. A government-appointed consultant (ThinkPlace Pty Ltd) stated that providing more resources would not be in the public interest. Instead, they recommended a more cost-effective and efficient approach: amalgamating all complaints into an information database from which the TGA could consider compliance priorities.

As a result, complaints were closed by sending complainants a letter stating that their complaints will be used for ‘intelligence’ to set priorities. The TGA said risk assessment informed whether a complaint was converted into a case for investigation or stored in their information database to determine future compliance priorities. Therapeutic goods associated with COVID-19 were declared ‘priority 1’, while weight loss, hangover, and four other products groups were said to be ‘priority 2’.

A focus on COVID-19 stimulated the TGA to deal with some of these complaints more effectively. However, apart from token action on individual products, no systemic action was taken on weight loss, hangover products and many other objects of our complaints.

More recently, the TGA’s complaint database for 2018 -2020 has been removed and replaced by a new database containing only a few complaints pre-2021. In addition, the fields of many ‘products’ and ‘responsible person’, are missing. The TGA say that migration of data to the new system is continuing. Meanwhile, complainants now only receive an automated acknowledgment.

Transparency remains a problem as there is no clear indication of how many complaints the TGA receives, what they are about, how many are filed for ‘intelligence’’, how many are actioned, and what outcome eventuates.

Given this lamentable state of affairs, in association with Australian Skeptics, it is proposed to publish reports on all complaints submitted to the TGA in 2022 and their outcomes. Past experience shows that documenting problems, pointing out underlying issues and putting forward solutions can produce progress. But patience and persistence are required.

FSM has grappled with unethical advertising of pseudo-medical interventions. Controls differ for practitioners regulated by the Australian Health Practitioner Regulation Agency (AHPRA) and those regulated by State and Territory Health Complaints Commissioners. The former includes medical practitioners, pharmacists, nurses, chiropractors, osteopaths, and Traditional Chinese Medicine practitioners. The latter includes naturopaths, homeopaths, and practitioners of western herbal medicine.

FSM has held regular meetings with AHPRA senior managers. We have also met several of their national boards and attended stakeholder forums. Chiropractic was an initial focus. Many practitioners advertised that chiropractic care in pregnancy could shorten labour duration and prevent caesarean delivery – despite the absence of evidence. Pregnant women were warned that labour often resulted in the newborn babe’s spinal misalignment, which could lead to numerous problems unless put right by regular chiropractic adjustments. It was also claimed that chiropractic ‘adjustments’ could improve attention deficit hyperactivity disorder, infantile colic, and ear infection.

In 2015, FSM submitted hundreds of complaints to AHPRA, alleging that chiropractic websites were in breach of both s.133 of the Health Practitioner Regulation National Law Act 2009 and the Chiropractic Board of Australia’s Guidelines for advertising regulated health services. These provisions prohibit advertising which is false, misleading, or deceptive, creates an unreasonable expectation of beneficial treatment, or can encourage the indiscriminate or unnecessary use of health services.

Five years have passed since the Chiropractic Board first asked practitioners to ensure that their websites met legal advertising requirements. Over this time, the Board’s sole approach to this problem was educational. Although chiropractors consistently had the highest advertising complaints of all practitioners (38 per 1,000 chiropractors in 2013–14), no penalties nor disciplinary action had been applied for advertising offences.

FSM argued that repeated advertising offences required appropriate penalties. We also pointed out that some practitioners now invited patients to consult them about services they were no longer permitted to advertise. We said that limitations should be placed on chiropractic practice which lacked evidence.

AHPRA responded that, although it could act on misleading advertising, it had no power to restrict the scope of practice of chiropractors (or other registered practitioners). We said that, if lack of good evidence makes it illegal to publicly advertise a treatment, then it should be equally illegal to offer it to patients privately; after all, the real harm is caused by the treatment, not the advertising.

In 2019, following damning publicity and further representations, the Victorian Health Minister eventually instructed Safer Care Victoria (SCV) to undertake an independent review of the practice of chiropractic spinal manipulation on children under 12 years. The result was a recommendation that spinal manipulation should not be provided to children under 12 years of age, for general wellness or for the management of conditions such as hyperactivity disorders, infantile colic, or ear infections.

The Chiropractic Board has also stated that chiropractors are not trained to apply any direct treatment to an unborn child and should not deliver any treatment to the unborn child. Neither should they provide materials, information or advice that is anti-vaccination in nature. After numerous complaints from FSM members, the Chiropractic Board finally referred a prominent anti-vax chiropractor, Simon Floreani, to the Victorian Civil and Administrative Tribunal (VCAT). His registration was suspended for 6 months, and conditions placed on his re-registration.

FSM has not just been concerned about chiropractors. We have complained (with varied success) about medical practitioners promoting stem cell therapy for multiple sclerosis, Traditional Chinese Medical practitioners claiming that acupuncture can treat infertility and dubious laboratory tests used in complementary and alternative medicine.

In conclusion, the peddling of unproven and sometimes dangerous remedies has existed throughout human history.

There will always be companies (and individuals) who put the pursuit of profit before ethical behaviour. There will always be advocates for de-regulation and regulators captured by industry. To protect consumers there must be opposing forces. That is the role that FSM is proud to play, along with colleagues from the sceptical community and consumer movements.

Appendix

FSM activities and outcomes (often in association with others), 2011-2021.

  1. Removal of extravagant claims for acupuncture from the World Health Organization website and instigation of a WHO evidence review.
  2. Involvement in the 2015 Review of the Australian Government Rebate on Private Health Insurance for Natural Therapies. This led to removal of cover for therapies that lacked evidence such as homeopathy, iridology, reflexology and naturopathy (currently being reviewed again to see if additional evidence exits).
  3. Removal of unproven/disproven courses or modules from Australian universities.
  4. Removal of continuing professional development (CPD) points required annually by relevant registered practitioners for a number of AltMed courses.
  5. Following complaints to the TGA, removal of some illegal medicines not on the Australian Register of Therapeutic Goods (ARTG).
  6. De-listing some complementary medicines and medical devices (such as ‘bio-resonance’ machines) lacking evidence.
  7. Getting the TGA to declare two products of self-declared ‘Foods for special medical purposes’ illegal therapeutic goods and have them removed from the market-place.
  8. Publishing academic articles, in peer-reviewed journals, documenting regulatory problems investigated and solutions suggested.
  9. Publishing articles in lay media on current problems including in The Conversation, MJA Insight and Pearls and Irritations (around 200 over the last 5 years).
  10. Responding to consultation requests from the TGA, Medical Boards, National Medicines Policy Review, and others.
  11. Achieving the suspension of anti-vax chiropractor Simon Floreani’s registration.
  12. Stimulating the Chiropractic Board to publish standards on pregnancy and paediatric care.
  13. Responsible for the setting up of AHPRA’s ‘Advertising Compliance’ section, including their pilot auditing system (yet to report).
  14. Responding to requests for information from journalists.
  15. Correction of misinformation from the Victorian government’s ‘Better Health’ Channel.
  16. Providing a complaints avenue for people who want to remain anonymous.

Yesterday, it was reported that one of Austria’s best-known opponents of vaccination has died as a result of coronavirus infection. He vehemently refused treatment in hospital. Instead, he insisted on treating himself – and tragically, he is not an isolated case.

Miracle Mineral Solution” (MMS) is being promoted as a treatment for all kinds of diseases – including, of course, the coronavirus. But MMS is nothing more than the bleach and disinfectant chlorine dioxide, or CDL for short. It made headlines when Donald Trump suggested it as a remedy against Covid-19. Subsequently, CDL became highly popular amongst the anti-vax brigade.

Johann Biacsics was one of the leading figures of the anti-vaccination scene in Austria. On 11 November, he was seen in a Vienna hospital with an acute corona infection. At this stage, he had already taken chlorine dioxide because of fever complaints. Biacsics was, of course, not vaccinated and refused treatment. He was firmly convinced that he had already overcome the infection thanks to his treatment with chlorine dioxide.

The senior physician at the Vienna hospital saw things differently. His condition was “life-threatening”, she said. But instead of accepting treatment in hospital, Biacsics discharged himself and said he would rather treat himself. Once home, Biacsics put in an IV line with chlorine dioxide and sodium chloride. Two days later he was dead.

Only two weeks before his death, Biacsics had demonstrated in Vienna against the Austrian Corona measures. In a television interview from September, he can be seen in front of the parliament. “There are mainly vaccinated people in the intensive care units. 67 percent of them are vaccinated,” he said on camera at the time. When the reporter corrected him, he only replied that he had “inside information”.

His followers are now suggesting that he was poisoned. And for once they are, of course, correct. He basically poisoned himself with MMS. His family, meanwhile, blames the hospital and claim that he did not die of COVID, nor that Biacsics’ death is the result of treatment with chlorine dioxide.

Biacsics is not the first Austrian Covid patient who has refused treatment or used “alternative remedies”. And he is not the first who has died as a result. Self-treatment is booming among vaccination opponents and Corona deniers. It was even propagated in the Austrian parliament. For weeks, FPÖ leader Herbert Kickl (who also is COVID-positive) and his party colleagues have been promoting the deworming drug ivermectin – despite warnings from doctors, scientists, and the manufacturer.

All too often, the consequences are fatal: In Styria, two patients died from poisoning with ivermectin, in the district of Rohrbach in Upper Austria, a Corona patient left the intensive care unit in critical condition and died. He had also relied on ivermectin and refused other treatments.

 

Conspiracy beliefs are associated with detrimental health attitudes during the coronavirus pandemic. Prior research on these issues was mostly cross-sectional, however, and restricted to attitudes or behavioral intentions. This investigation was designed to examine to what extent conspiracy beliefs predict health behavior and well-being over a longer period of time.

In this multi-wave study on a large (N = 5745) Dutch research panel (weighted to provide nationally representative population estimates), the researchers examined if conspiracy beliefs early in the pandemic (April 2020) would predict a range of concrete health and well-being outcomes eight months later (December 2020).

The results revealed that Covid-19 conspiracy beliefs prospectively predicted a decreased likelihood of getting tested for corona; if tested, an increased likelihood of the test coming out positive; and, an increased likelihood of having violated corona regulations, deteriorated economic outcomes (job loss; reduced income), experiences of social rejection, and decreased overall well-being. Most of these effects generalized to a broader susceptibility to conspiracy theories (i.e. conspiracy mentality).

The authors concluded that conspiracy beliefs are associated with a myriad of negative life outcomes in the long run. Conspiracy beliefs predict how well people have coped with the pandemic over a period of eight months, as reflected in their health behavior, and their economic and social well-being.

These findings tie in with another recent study that investigated whether individual beliefs and personal characteristics differences affect people’s likelihood of contracting COVID-19. In the early months of the pandemic, U.S. participants responded to a variety of individual difference measures as well as questions specific to the pandemic itself. Four months later, 2120 of these participants were asked whether they had contracted COVID-19. Nearly all of the included individual difference measures significantly predicted whether a person reported testing positive for the virus in this four-month period. Additional analyses revealed that all of these relationships were primarily mediated by whether participants held accurate knowledge about COVID-19.

I find it hard not to despair vis a vis such results. Not that they were not to be expected – if you ignore the existence of risk factors exist for heart attacks, it seems plausible that your likelihood of dying of myocardial infarction is increased. What is particularly desolating are two facts:

  • This pandemic seems to have rendered the voices of stupidity and ignorance loud and popular, even fashionable.
  • Those lunatics who adhere to conspiracy beliefs harm not merely themselves but endanger all of us.

I ask myself how we will ever get past this new age of unreason.

Neck pain affects a vast number of people and leads to reduced quality of life and high costs. Clinically, it is a difficult condition to manage, and the effect sizes of the currently available treatments are moderate at best. Activity and manual therapy are first-line treatment options in several guidelines. But how effective are they really?

This study investigated the combination of home stretching exercises and spinal manipulative therapy in a multicentre randomized controlled clinical trial, carried out in a multidiscipline range of primary care clinics.

The treatment modalities utilized were spinal manipulative therapy combined with home stretching exercises compared to home stretching exercises alone. Both groups received 4 treatments for 2 weeks. The primary outcome was pain, where the subjective pain experience was investigated by assessing pain intensity (NRS – 11) and the quality of pain (McGill Pain Questionnaire). Neck disability and health status were secondary outcomes, measured using the Neck Disability Indexthe EQ-5D, respectively.

One hundred thirty-one adult subjects were randomized to one of the two treatment groups. All subjects had experienced persistent or recurrent neck pain the previous 6 months and were blinded to the other group intervention. The clinicians provided treatment for subjects in both groups and could not be blinded. The researchers collecting data were blinded to treatment allocation, as was the statistician performing data analyses. An intention-to-treat analysis was used.

Sixty-six subjects were randomized to the intervention group, and 65 to the control group. For NRS – 11, a B-coefficient of – 0,01 was seen, indication a 0,01 improvement for the intervention group in relation to the control group at each time point with a p-value of 0,305. There were no statistically significant differences between groups for any of the outcome measures.

Four intense adverse events were reported in the study, three in the intervention group, and one in the control group. More adverse incidents were reported in the intervention group, with a mean pain intensity (NRS-11) of 2,75 compared to 1,22 in the control group. There were no statistically significant differences between the two groups.

The authors concluded that there is no additional treatment effect from adding spinal manipulative therapy to neck stretching exercises over 2 weeks for patients with persistent or recurrent neck pain.

This is a rigorous and well-reported study. It suggests that adjuvant manipulations are not just ineffective for neck pain, but also cause some adverse effects. This seems to confirm many previously discussed investigations concluding that chiropractors do not generate more good than harm for patients suffering from neck pain.

The effectiveness of manipulation versus mobilization for the management of spinal conditions, including cervicogenic headache, is conflicting, and a pragmatic approach comparing manipulation to mobilization has not been examined in a patient population with cervicogenic headache.

This study evaluated the effectiveness of manipulation compared to mobilization applied in a pragmatic fashion for patients with cervicogenic headache.

Forty-five (26 females) patients with cervicogenic headache were randomly assigned to receive either pragmatically selected manipulation or mobilization. Outcomes were measured at baseline, the second visit, discharge, and 1-month follow-up. The endpoints of the study included the Neck Disability Index (NDI), Numeric Pain Rating Scale (NPRS), the Headache Impact Test (HIT-6), the Global Rating of Change (GRC), the Patient Acceptable Symptoms Scale (PASS). The primary outcome measures were the effects of treatment on disability and pain. They were examined with a mixed-model analysis of variance (ANOVA), with treatment group (manipulation versus mobilization) as the between-subjects variable and time (baseline, 48 hours, discharge, and follow-up) as the within-subjects variable.

The interaction for the mixed model ANOVA was not statistically significant for NDI (p = 0.91), NPRS (p = 0.81), or HIT (p = 0.89). There was no significant difference between groups for the GRC or PASS.

The authors concluded that manipulation has similar effects on disability, pain, GRC, and cervical range of motion as mobilization when applied in a pragmatic fashion for patients with cervicogenic headaches.

Essentially, this study is an equivalence trial comparing one treatment to another. As such it would need a much larger sample size than the 45 patients enrolled by the investigators. If, however, we ignored this major flaw and assumed the results are valid, they would be consistent with both manipulation and mobilization being pure placebos.

I can imagine that many chiropractors find this conclusion unacceptable. Therefore, let me offer an alternative: both approaches were equally effective. Therefore, mobilization, which is associated with far fewer risks, is preferable. This means that patients suffering from cervicogenic headache should see an osteopath who is less likely to use manipulation than a chiropractor.

And again, I can imagine that many chiropractors find this conclusion unacceptable.

Long-COVID syndrome is a condition that will affect a large proportion of those who survived a COVID-19 infection. According to a recent meta-analysis, it is associated predominantly with poor quality of life, persistent symptoms including fatigue, dyspnea, anosmia, sleep disturbances, and mental health problems.

At present, we are still struggling to understand the exact causes and mechanisms of this condition. Therefore, its optimal treatment is as yet uncertain. Governments around the world have therefore made sizable research funds available to make progress in this area, and research in this area is frantically active.

Regardless of the evidence, practitioners and entrepreneurs of so-called alternative medicine (SCAM) are gearing up to jump on this bandwagon by declaring that their offerings are a solution to this growing problem. Indeed, many of them have already done so. Here are just three sites that I found today which are promoting homeopathy for long COVID:

One hardly needs to mention that homeopathy is not supported by sound evidence in the management of long-Covid (or any other condition for that matter). Neither does one need to stress that homeopaths are just one example, and virtually all other SCAM providers are promoting their services in the absence of evidence.

A recent review of the literature stated this:

Patients with long COVID commonly refer to taking ‘the stack’ or ‘the supplement stack’, which includes high-dose vitamin C and D, niacin (nicotinic acid), quercetin, zinc, selenium, and sometimes also magnesium. Further research is needed to confirm or refute the impact of supplements in long COVID. Examples of noteworthy interactions with supplements include: niacin causing an increased risk of bleeding events when combined with selective serotonin reuptake inhibitors or non-steroidal anti-inflammatory drugs, increased risk of rhabdomyolysis together with statins, and quercetin causing inhibition and induction of various human cytochrome P450 enzymes.

Why then are SCAM providers promoting SCAM for long-COVID?

This is a daft question if there ever was one.

It seems obvious they do it because:

  • they are believers who don’t care about evidence,
  • they are in it for the money,
  • or both.

Some time ago, this homeopath already indicated, that SCAM providers should see COVID as an opportunity: For homeopathy, shunned during its 200 years of existence by conventional medicine, this outbreak is a key opportunity to show potentially the contribution it can make in treating COVID-19 patients. We should perhaps not hold our breath to see the emergence of convincing evidence, but we should be prepared to warn the public of getting exploited by charlatans who disregard both ethics and evidence.

‘Survive Cancer’ is a UK charity that promotes and researches orthomolecular medicine in the treatment of cancer, septic shock, mental health, and other illnesses. They claim to provide information about research and trials and a multi-pronged treatment approach for sufferers of cancer. Specifically for cancer, they recommend the following ‘top ten‘ so-called alternative medicines (SCAMs):

  • Gerson
  • Vitamin C therapy
  • Anti-angiogenic therapy
  • Immunotherapy
  • Photodynamic-/Photo-therapy
  • Melatonin
  • Bisphosphonates (for bone cancer)
  • Coley’s toxins
  • Salvestrols
  • Pain management

Interesting?

Yes, because it is misleading to the extreme. Here, for example, is what they say about an old favorite of mine (and of Prince Charles):

Gerson Therapy

Max Gerson was a German doctor who in the early twentieth century devised an anti-cancer diet and regime based on radically altering the sodium/potassium ratio in the body for the better, thus allowing optimal cellular functions, and nutrition, coupled with intensive detoxification through the use of coffee enemas.

Coffee enemas (see Detox, in First Steps, 5 Rs of Cancer Survival,) are a scientifically established, and medically accepted, way of stimulating the production of glutathione-s-transferases, a major liver detoxifying enzyme family. The diet is vegetarian, low in protein, with fresh organic fruit and vegetable juices daily, and certain specified supplements, such as potassium, niacin and vitamin C. At the end of his life Gerson testified before Congress with the details of 50 cases he had cured. His daughter, Charlotte, has continued Gerson’s work in the U.S. However, she has not made an attempt to integrate modern nutritional state-of-the-art knowledge into the therapy. This is being done by Gar Hildebrand. A retrospective study showed that the Gerson therapy is much more effective than chemotherapy for ovarian cancer and melanoma, both particularly aggressive forms of cancer. Gerson himself had notable successes with various kinds of brain tumour, even after some neurological damage had occurred. Orthomolecular Oncology suggests combining Immunopower with Gerson as an update. We can also cite a remarkable case of a 11 year remission in Multiple Myeloma, another fast-moving, relentless cancer without conventional cure, otherwise conventionally untreated, achieved through a combination of Gerson and modern orthomolecular approaches. Gerson is a powerful, comprehensive therapy, still capable of producing cures, even in its unmodulated form. However, it requires great discipline, time, and extra assistance. Read Gerson’s book and/or contact the Gerson Institute for further details.

One does not need to be a genius to predict that cancer patients following this sort of advice, will significantly shorten their lives, diminish their quality of life and empty their bank account. One does, however, need to be a genius to predict when the UK charity commission is finally going to do something about the many UK charities that prey on vulnerable cancer patients.

PS

I almost forgot: the patrons of this charity are:

In a recently published study, the willingness to be vaccinated of parents of underage children and persons without underage children was examined. The study was based on a random sample (telephone survey, n = 2014, survey between 12.11.2020 and 10.12.2020).
The results revealed that parents consistently show a lower propensity to vaccinate with a COVID-19 vaccine than respondents without minor children (54.1% vs. 71.1%). Fathers showed a more pronounced own willingness to vaccinate than mothers. Furthermore, men were more willing than women to have their own child vaccinated with a COVID-19 vaccine.
The overall sample also showed that a rejection of so-called alternative medicine (SCAM) was associated with a significantly higher willingness to be vaccinated. There was also a significant correlation between the attitude towards homeopathy and one’s own willingness to be vaccinated. If homeopathy was supported, the willingness to vaccinate was lower. This correlation between the attitude towards homeopathy and willingness to vaccinate was also evident in the sub-sample of parents. Among the parents, it was again the women who significantly more often had a positive attitude towards homeopathy than men, who more often do not think anything of it.

This new evidence ties in neatly with many of my previous posts on the subject of SCAM and vaccination, for instance:

Collectively, this evidence tells us that:

  • the effect has been shown in many different ways,
  • it can therefore be assumed to be real,
  • it is not confined to COVID vaccinations,
  • it is not confined to one particular branch of SCAM,
  • it even affects MDs (who surely should know better) dabbling in SCAM,
  • it has a long history,
  • it is prevalent in many, if not most countries,
  • it does real harm.

So, the next time someone tells you that SCAM and SCAM practitioners have a positive influence on public health, tell them to think again.

 

I have said it often before, and I will say it again:

Homeopathy and other ineffective so-called alternative medicines (SCAMs) are dangerous mostly because they might replace effective treatments.

The tragic death of an Austrian boy is a stark reminder of this fact. Even though this happened a decade ago, I only just came across this case. It was, to the best of my knowledge, never published in English. Allow me, therefore, to summarize it here:

In 2011, a judge sentenced a couple from East Tyrol to a one-year suspended sentence. Their son, who suffered from a rare congenital immune system disorder (SCID*), had been treated only with homeopathy until he died. The doctor who treated the boy in this way received the same sentence.** The verdicts took into account that the parents and the family doctor did not act out of sheer ignorance, but had been informed about the nature of the disease and its consequences.

The parents told the court that they had previously had extremely negative experiences with conventional medicine when their first two children, who suffered from the same condition, had died. When their third child fell ill, the parents took him to a clinic where a bone marrow transplant was to be carried out, which, according to an expert witness, would have had a 95 % chance of curing the boy. Because the parents were put off by the sight of other children in the hospital, they took their son home again and withheld all further conventional treatments or appropriate examinations. Instead, they instructed their family doctor to cure the boy with homeopathy. The doctor refrained from administering antibiotics when the illness worsened due to an infection and failed to admit the boy to a hospital when he became severely ill.

The child then died of sepsis. The autopsy revealed that he was malnourished and one of his ear canals as well as his lungs were necrotic with inflammation.

______________________

It is hard not to be repulsed and nauseated by such stories. They show how dangerously unreasonable some homeopaths and their followers are. And they remind us that even a seemingly harmless SCAM will cost lives in the hands of such fanatics.

 

* Severe combined immunodeficiency (SCID) is a group of rare disorders caused by mutations in different genes involved in the development and function of infection-fighting immune cells. Infants with SCID appear healthy at birth but are highly susceptible to severe infections. The condition is fatal, usually within the first year or two of life, unless infants receive immune-restoring treatments, such as transplants of blood-forming stem cells, gene therapy, or enzyme therapy.

**Personally, I find the sentence for the doctor far too lenient. One could argue that the parents had been punished by the loss of their child and thus deserve merci, but the doctor?

This post has no direct relation to so-called alternative medicine (SCAM), except that many fans of SCAM and most anti-vaxxers claim that COVID-19 is ‘just a flu’ and therefore should not be taken all that seriously. A little bit of this or that SCAM is surely enough for protecting us, they claim. To all who are of this opinion, I recommend reading this new BMJ paper very carefully.

This analysis aimed at estimating the changes in life expectancy and years of life lost in 2020 associated with the covid-19 pandemic. A time-series analysis was undertaken with the data from 37 upper-middle and high-income countries or regions with reliable and complete mortality data. The annual all-cause mortality data from the Human Mortality Database for 2005-20 were used, harmonized, and disaggregated by age and sex.

The reduction in life expectancy was estimated as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table.

A reduction in life expectancy in men and women was observed in all the countries studied except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. No evidence was found of a change in life expectancy in Denmark, Iceland, and South Korea. The highest reduction in life expectancy was observed in

  • Russia (men: −2.33, 95% confidence interval −2.50 to −2.17; women: −2.14, −2.25 to −2.03),
  • the United States (men: −2.27, −2.39 to −2.15; women: −1.61, −1.70 to −1.51),
  • Bulgaria (men: −1.96, −2.11 to −1.81; women: −1.37, −1.74 to −1.01),
  • Lithuania (men: −1.83, −2.07 to −1.59; women: −1.21, −1.36 to −1.05),
  • Chile (men: −1.64, −1.97 to −1.32; women: −0.88, −1.28 to −0.50),
  • Spain (men: −1.35, −1.53 to −1.18; women: −1.13, −1.37 to −0.90).

Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million (95% confidence interval 26.8m to 29.5m) years of life lost more than expected (17.3 million (16.8m to 17.8m) in men and 10.8 million (10.4m to 11.3m) in women). The highest excess years of life lost per 100 000 population were observed in

  • Bulgaria (men: 7260, 95% confidence interval 6820 to 7710; women: 3730, 2740 to 4730),
  • Russia (men: 7020, 6550 to 7480; women: 4760, 4530 to 4990),
  • Lithuania (men: 5430, 4750 to 6070; women: 2640, 2310 to 2980),
  • the US (men: 4350, 4170 to 4530; women: 2430, 2320 to 2550),
  • Poland (men: 3830, 3540 to 4120; women: 1830, 1630 to 2040),
  • Hungary (men: 2770, 2490 to 3040; women: 1920, 1590 to 2240).

The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2000 per 100 000.

The authors concluded that more than 28 million excess years of life were lost in 2020 in 31 countries, with a higher rate in men than women. Excess years of life lost associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.

_______________________

I hope (yet, sadly, I am not sure) that this will silence all those who like to claim:

it’s just a flu!

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