Dr. John Ioaniddis, April 2020
This post isn’t about Dr. John Ioaniddis, but I’ll start with an optimistic prediction he made on April 9, 2020. Dr. Ioannidis said:
If I were to make an informed estimate based on the limited testing data we have, I would say that covid-19 will result in fewer than 40,000 deaths this season in the USA.
By April 9, 2020, 21,993 Americans had already died of COVID, and COVID’s death toll that day was 1,921 people. Dr. Ioannidis was predicting that only 18,000 more people would die of COVID “this season”, and he did so on a day when 799 people died in New York State alone, breaking the record for daily COVID deaths for the third straight day. Over 7,000 New Yorkers had died already. Unless COVID vanished instantly, Dr. Ioannidis’ prediction would age poorly within a week.
Indeed, by April 17, 2020, America’s COVID death toll was 39,581, and 2,197 people died that day. Though his prediction of 40,000 deaths was falsified in 8 days, Dr. Ioannidis was unfazed. In fact, on the very day his prediction was proven wrong, he gave an interview in which he continued to minimize the virus. He said that based on a flawed Santa Clara antibody study:
We realize that the number of infected people is somewhere between 50 and 85 times more compared to what we thought, compared to what had been documented. Immediately, that means that the infection fatality rate, the chance of dying, the probability of dying, if you are infected, diminishes by 50-85 fold, because the denominator in the calculation becomes 50-85 fold bigger. If you take these numbers into account, they suggest that the infection fatality rate for this new coronavirus is likely to be in the same ballpark as seasonal influenza…
Our data suggests that COVID-19 has an infection fatality rate that is in the same ballpark as seasonal influenza. It suggests that even though this is a very serious problem, we should not fear. It suggests that we have solid ground to have optimism about the possibility of eventually reopening our society and gaining back our lives…We have data now that the infection fatality rate is much, much lower, compared to our original expectations and fears. I think that there is no reason to fear.
Dr. Ioannidis thought that hospitals were being overrun with the worried well. He said:
I think that in many of these places, unfortunately, we saw many people going to the hospital probably under a sense of fear and threat and panic, and we had the environment heavily contaminated, generating hospital chains of infection and therefore infecting lots of people who were very susceptible, and who would do very poorly if, on top of whatever they had, they also got COVID-19 infection.
No one who worked in a COVID hotspot at that time ever said anything that absurd. Healthcare workers used war analogies to describe what was happening. One traveling nurse, who served in Iraq and Afghanistan, estimated that he saw 3,000 people die of COVID, saying “War doesn’t even compare to this…I would rather die, any other way of dying, than dying with coronavirus”. A doctor at Elmhurst Hospital in Queens said:
If you watch a war movie to see people shooting from all over, that’s what this almost felt like. One thing after the next after next, you can’t even catch up with what has to happen.
Three days later, on April 20th, 2020, Dr. Ioannidis appeared on a Fox News program hosted by right-wing firebrand Mark Levin. Dr. Ioannidis said the risk of dying from COVID was high for elderly people, especially those in nursing homes, and for those with serious underlying conditions. Though 46,000 Americans were now dead, Dr. Ioannidis continued to minimize the virus for everyone else. He said “most of the population has minimal risk, in the range of dying while you’re driving from home to work and back”. He said the infection fatality rate is “probably in the range of 1 in a 1,000”. Mr. Levin repeated the good news by saying, “You say one in a thousand. You’re saying well under 1%, is that one-tenth of 1% of the population that actually has the virus will pass away as a result of the virus, or in connection to the virus”.
New York City had already recorded over 10,000 COVID deaths the week before this interview. If 10,000 people had already died and if only 1 in a 1,000 people died overall, this would require 10 million New Yorkers to have been infected, when only 8.3 million people live there. Given that a million Americans have now died of COVID, an infection fatality rate of 1 in 1,000 would require 1 billion infections, triple the population of the entire country.
So by April 20th, 2020, Dr. Ioannidis had already had one optimistic prediction obliterated in 8 days, and his response was to calculate an infection fatality rate so low, it required that over 100% of New Yorkers had already contracted COVID.
“Scientists Who Express Different Views on Covid-19 Should be Heard, Not Demonized”
With this in mind, let’s revisit an article that was published on April 27, 2020, titled “Scientists Who Express Different Views on Covid-19 Should be Heard, Not Demonized” By Drs. Vinay Prasad and Jeffrey S. Flier, the Higginson Professor of Physiology and Medicine, Harvard University Distinguished Service Professor, and Former Dean of the Faculty of Medicine (2007- 2016). Their article said:
When major decisions must be made amid high scientific uncertainty, as is the case with Covid-19, we can’t afford to silence or demonize professional colleagues with heterodox views. Even worse, we can’t allow questions of science, medicine, and public health to become captives of tribalized politics. Today, more than ever, we need vigorous academic debate.
To be clear, Americans have no obligation to take every scientist’s idea seriously. Misinformation about Covid-19 is abundant. From snake-oil cures to conspiracy theories about the origin of SARS-CoV-2, the virus that causes the disease, the internet is awash with baseless, often harmful ideas. We denounce these: Some ideas and people can and should be dismissed.
Although their article appeared after 60,000 Americans had died of COVID, 20,000 more than Dr. Ioannidis predicted, Drs. Prasad and Flier said we had an obligation to take his every idea seriously. Dr. Ioannidis’ view that COVID was “in the same ballpark as seasonal influenza” was not to be dismissed. They said he was an “independent thinker” expressing “heterodox views”. Their article concluded:
Scientific consensus is important, but it isn’t uncommon when some of the most important voices turn out to be those of independent thinkers, like John Ioannidis, whose views were initially doubted. That’s not an argument for prematurely accepting his contestable views, but it is a sound argument for keeping him, and others like him, at the table.
According to Drs. Prasad and Flier, Dr. Ioannidis was just expressing “heterodox views” when he continued to minimize COVID on the very day its death toll exceeded his prediction of 40,000 deaths. Dr. Ioannidis was just being an “independent thinker” when he calculated that 120% of New Yorkers contracted COVID by April 2020. Though the internet is “awash with baseless, often harmful ideas,” a world-famous scientist from Stanford can never have anything to do with that. Anyone who argues otherwise is trying to squash “vigorous academic debate”.
Though I disagree, I will reiterate a point that both myself and Dr. David Gorski have stated previously: Threats and vulgarities against scientists and doctors are always horrific and indefensible.
“Herd immunity was going to save us, and this thing was going to go bye-bye”
However, for the most part, Drs. Prasad and Flier have reason to celebrate. If we fantasize that Dr. Ioannidis’ critics were actually was trying to “silence” him in April 2020, they failed miserably. He was a loud, ubiquitous, and influential presence, especially at that time. According to one news article from December 2020, “He had appeared at least 18 times on major cable news networks, repeatedly questioning the severity of the pandemic.” Stephanie Lee further reported that Dr. Ioannidis’ optimistic predictions:
Caught the eye of many conservative commentators, from Ann Coulter to Fox News personality Lisa Boothe. Bret Stephens cited it in a New York Times columntitled “It’s Dangerous to Be Ruled by Fear.” It also circulated among West Wing aides, Bloomberg reported.
Dr. Ioannidis has continued to be interviewed by the media and on podcasts since. While the market for doctors predicting the end of the pandemic has since become saturated, Dr. Ioannidis continues to make his opinions known. One article from March 2022 said, “John Ioannidis: ‘Public Health Officials Need to Declare the End of the Pandemic.'” Of course, this is what he’s said the entire pandemic, not just in niche academic conferences and journals, but in interviews seen by many millions of people.
Dr. Ioannidis also got his seat at the table. Dr. Scott Atlas, an anti-vaccine doctor who served as President Trump’s COVID advisor took his ideas to the top, and this started early on. On March 20, 2020, Dr. Atlas sent an email to Centers for Medicare and Medicaid Services Administrator Seema Verma in which he the “virus would cause about 10,000 deaths.” He claimed this number “would be unnoticed” in a normal flu season. The House Select Subcommittee on the Coronavirus Crisis revealed the unsurprising news that Dr. Atlas took these words directly from Dr. Ioannidis, who was saying exactly this at the time.
Once he arrived at the White House, Dr. Atlas worked only “to convince people that herd immunity was going to save us, and this thing was going to go bye-bye” according to the CDC Director Robert Redfield. I urge you to read The Altas Dogma, the damning report by the House Select Subcommittee, detailing the real-world consequences of Dr. Atlas’ misinformation. Here’s an excerpt:
Dr. Atlas also used his newfound position of power to recruit herd immunity proponents to come to Washington, D.C., to meet with multiple senior Administration officials and, according to Director Redfield, “convince people that herd immunity was going to save us, and this thing was going to go bye-bye.” In August 2020, Dr. Atlas successfully arranged for three herd immunity proponents to meet with President Trump and Vice President Mike Pence to discuss their views on the pandemic response—which went forward despite Dr. Birx expressing concerns to the Vice President’s Chief of Staff Marc Short and other senior officials and refusing to attend. In October 2020, Dr. Atlas coordinated a meeting between HHS Secretary Alex Azar and the authors of the discredited “Great Barrington Declaration,” which advocated for the herd immunity strategy that Dr. Atlas was actively promoting. Secretary Azar issued a tweet after the meeting recognizing that the approach articulated by the Great Barrington Declaration authors was a “strong reinforcement” of the Trump Administration’s ongoing response strategy.
Dr. Atlas openly credited Dr. Ioannidis in a recent article ironically titled “When Will Academia Account for Its Covid Failures?”. Dr. Atlas wrote:
Virtually every scientific point I made exactly matched those of Jay Bhattacharya and John Ioannidis, both Stanford professors of medicine, including the risk for children, spread from children, focused protection, postinfection immunity, masks, and the harm from school closures and lockdowns.
Drs. Prasad and Flier got their wish. Dr. Ioannidis turned out to be one of the “most important voices” this pandemic. Dr. Atlas later wrote he was in touch with Dr. Ioannidis frequently during his tenure in the Trump administration. The idea that “herd immunity was going to save us, and this thing was going to go bye-bye” became policy. Countless millions of Americans believed this too. You can judge the results.
“Society faces a risk even more toxic and deadly than Covid-19”
Drs. Prasad and Flier also wrote:
Society faces a risk even more toxic and deadly than Covid-19: that the conduct of science becomes indistinguishable from politics.
Dr. Flier recently revisited his article and said he “wouldn’t change a word.” I would. COVID killed over a million Americans and sickened many millions more. Nothing was more toxic and deadly than the virus, and only someone sheltered from it horrors could claim otherwise.
But misinformation was one of the main reasons COVID was so toxic and deadly. Tens of millions of Americans falsely believed the virus posed no risk to them, the pandemic was over, the death toll was inflated, that death certificates couldn’t be trusted, and that doctors killed patients through premature intubations. They learned this all from a respected scientist, aided by respected supporters who told them his absurd predictions and impossible calculations were actually the words of a “heterodox” scientist, and “independent thinker”. Is it any wonder why so many Americans refused a COVID vaccine?
The constant bleating about “silencing heterodox thinkers” overlooks many obvious things. Not only were these “silenced” doctors very loud and very influential, they were wrong and they were obviously wrong. Society faces a toxic and deadly risk when patently absurd ideas get reframed as “heterodox”. Society faces a toxic and deadly risk when those who espouse patently absurd ideas are seated at the head of at the table. Society faces a toxic and deadly risk when a respected scientist who easily speaks in scientific jargon can say damn near anything and still have esteemed members of the medical establishment rally to his defense. Society faces a toxic and deadly risk when strident critics are falsely labeled censors.
No one wants to be called a censor, and ironically, mislabeling one’s critics as “censors” is a very effective way to censor one’s critics.
Of course, no one wants unorthodox beliefs to be labeled as “misinformation.” We need to leave room for people to have good faith disagreements without being smeared as “anti-vaccine” or “anti-science.” We need to be open to outliers and mavericks. The inspirational story of Dr. Katalin Kariko, the unappreciated scientist whose work paved the way for mRNA vaccines, shows why this is so. No doctor should be fearful to challenge medical dogma, so long as they have evidence and are willing to admit error if their pet theory doesn’t pan out. (Dr. Ioannidis is now making cringeworthy, self-congratulatory movies about how right he was. “Death is a beautiful woman that you can be in love with but you don’t want to meet,” he said.)
However, “vigorous academic debate” requires some semblance of a shared reality, and basic facts are not up for “debate”. It’s impossible to have a meaningful conversation with a misinformed interlocutor- and there are many- who insists COVID is just the flu, it poses a “negligible” risk to healthy people younger than 65, and the pandemic ended long ago.
Nasty words to a secure, famous scientist are just nasty words.
Misinformation is censorship.