I wish I had been wrong on this point. Unfortunately, I am afraid I might have been correct.
In July 2022, Dr. John Ioannidis had the following exchange with Dr. Vinay Prasad, who sought to discredit and silence his critics by reframing mere disagreements as “vicious attacks”:
Dr. Prasad: Early in the pandemic you were viciously attacked for expressing a policy viewpoint and intuition that is different from others. In a number of ways your core thesis was: in an effort— well intentioned—to control the coronavirus, we may inflict great damage on ourselves. That lesson appears to be borne out in a number of historical and recent events. How do you judge you original intuition?
Dr. Ioannidis: I wish I had been wrong on this point. Unfortunately, I am afraid I might have been correct.
Knowing that Dr. Ioannidis feels his “original intuition” has been vindicated, let’s turn to his discussion of his “biggest mistake.”
If only part of resources mobilized to implement extreme measures for COVID-19 had been invested towards enhancing influenza vaccination uptake, tens of thousands of influenza deaths might have been averted.
Though Dr. Ioannidis never treated a COVID patient, this didn’t stop him from making a self-congratulatory movie titled Out to See. In it, he made the following statement:
The biggest mistakes I am sure are mine.
Though Dr. Ioannidis laughed with an aura of faux humility when he said this, indicating he didn’t believe it, I won’t argue with him about it. While there’s a lot of competition, it’s hard to think of another scientist who was so wrong, early, so consistently, and so publicly.
To pick one example amongst many, I suggest reading his paper Coronavirus Disease 2019: The Harms of Exaggerated Information and Non-Evidence-Based Measures which was published on March 19, 2020. Though COVID had claimed its first American victim just a month prior, Dr. Ioannidis was very confident about this very new virus.
He wrote about “exaggerated pandemic estimates”, “exaggerated case fatality rate”, and “exaggerated exponential community spread.” He said a claim that 20%-60% of adults would be infected, was “substantially exaggerated.” He said, “China data are more compatible with close contact rather than wide community spread being the main mode of transmission.” He said that, “Even if COVID-19 is not a 1918-recap in infection-related deaths, some coronavirus may match the 1918 pandemic in future seasons. Thus, we should learn and be better prepared.” He felt this coronavirus was a false alarm. He wrote:
If only part of resources mobilized to implement extreme measures for COVID-19 had been invested towards enhancing influenza vaccination uptake, tens of thousands of influenza deaths might have been averted.
In reality, the CDC estimates that 51,000 Americans died of flu during the 2019-2023 flu seasons. COVID, meanwhile, killed 95,000 Americans in January 2021 alone.
Most of the population has minimal risk, in the range of dying while you’re driving from home to work and back.
If I had written that paper, I’d hope I’d say “I underestimated COVID” if I were to discuss my biggest mistake. This would especially be the case if I spread such sanguine sentiments widely in the media, including many YouTube videos and the programs of Fox News firebrands Mark Levin and Laura Ingraham. Indeed, an article about Dr. Ioannidis from December 2020 said:
He had appeared at least 18 times on major cable news networks, repeatedly questioning the severity of the pandemic.
During some of these appearances, Dr. Ioannidis told viewers to distrust everything they’d heard so far. In his appearance with Mr. Levin on April 2020, for example, he said that “the evidence we had early in the pandemic was utterly unreliable.” He said predictions of mass death were “completely off, it is just an astronomical error.” Dr. Ioannidis then told viewers he had newer and better data. This data was what most of us wanted to hear: except for older, vulnerable people, COVID was a nothingburger. According to Dr. Ioannidis, “the vast majority” of people:
Don’t even realize that they have been infected, they are asymptomatic, they have no symptoms, or they have very mild symptoms that they would not even bother to do anything about.
He said the risk of dying from COVID was high for elderly people, especially those in nursing homes and those with serious underlying diseases, but “most of the population has minimal risk, in the range of dying while you’re driving from home to work and back.” Dr. Ioannidis told Mr. Levin that 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.” Dr. Ioannidis did not consider that people could survive COVID, but be injured by it.
Dr. Ioannidis also suggested that “99% of people” who did succumb to the virus were “people would have died anyhow.” He said:
Because for the data that we have more mature and detailed information, like the data from Italy that has already through the peak of their epidemic wave, we realize that 99% of people who die with this virus have other reasons as well to die. On average, they have close to three other reasons to die. On average they are 80-years-old with other comorbidities, as we say, and there’s quite some debate on whether these people would have died anyhow, if not immediately, you know, perhaps in a few days or in a few weeks or a few months. In our country we see a fairly similar picture.
You should really watch the whole video.
On CNN, he called COVID a “common and mild infection” for most people. In another interview from April 2020, he said:
I would say that covid-19 will result in fewer than 40,000 deaths this season in the USA.
The USA would surpass 40,000 deaths 8-days later.
In an interview on YouTube he said “the infection fatality rate for this new coronavirus was likely to be in the same ballpark as seasonal influenza.” He said “For someone who is less than 65 and has no underlying diseases, the risk is completely negligible…these deaths are extremely exceptional.” He would later say “For people younger than 45, the infection fatality rate is almost 0%.”
In contrast, Dr. Ioannidis was very concerned about about measures to contain the virus. He warned they could lead to “financial crisis, unrest, civil strife, war, and a meltdown of the social fabric” and said:
I think the devastation can be extreme and it can be far worse than anything coronavirus can do.
As a reminder, the bodies of COVID victims were filling up giant refrigerated trucks throughout New York City at the time. “It was almost like a war,” said one doctor who actually saw what the virus could do.
A million Americans have died since of COVID, including 45,000 people younger than 45. In fact, COVID was the number 1 or 2 killer of young adults age 35-44 for six months in a row, from August 2021 to January 2022. It was the number 2 killer of adults age 25-34 for 5 out of 6 months during that time, and a top 10 killer for people younger than this. COVID’s grim toll would have been much higher had we let it spread freely amongst hundreds of millions of unvaccinated, “not vulnerable” Americans in 2020 as some doctors suggested.
Meanwhile, Dr. Ioannidis reflects back at these 2020 comments and concludes:
I wish I had been wrong on this point. Unfortunately, I am afraid I might have been correct.
I think our ideas have inflitrated [sic] the White House regardless
In addition to spreading this optimistic message widely in the media, Dr. Ioannidis sought to directly influence politicians as well. According to the reporting of Stephanie Lee:
In late March, as COVID-19 cases overran hospitals overseas, Ioannidis tried to organize a meeting at the White House where he and a small band of colleagues would caution the president against “shutting down the country for [a] very long time and jeopardizing so many lives in doing this,” according to a statement Ioannidis submitted on the group’s behalf. Their goal, the statement said, was “to both save more lives and avoid serious damage to the US economy using the most reliable data.”
Although the meeting did not happen, Ioannidis believed their message had reached the right people. Within a day of him sending it to the White House, Trump announced that he wanted the country reopened by Easter. “I think our ideas have inflitrated [sic] the White House regardless,” Ioannidis told his collaborators on March 28, in one of dozens of emails that BuzzFeed News obtained through public records requests.
Later, pro-infection, anti-vaccine doctor Scott Atlas revealed that he had “near daily discussions” with Dr. Ioannidis during his tenure as Trump’s COVID advisor, and that Dr. Ioannidis “kept reassuring me that my interpretations of the data was accurate and insisted I persevere”. Dr. Atlas persevered, unfortunately, though his interpretations of the data were not accurate.
I underestimated how much power politics and media and powers outside of science, could have on science.
Despite this inglorious track record, Dr. Ioannidis did not say “I underestimated COVID” when reflecting on his “biggest mistake”. Instead, he said his “biggest mistake” was that he underestimated something else. He said:
So I think that science is about mistakes, it’s about making mistakes, but trying to realize them and compare them with what might be better evidence and hopefully correct them as quickly as possible. And I think my biggest mistake, and I think that others can probably think about their mistakes, is that I underestimated how much power politics and media and powers outside of science, could have on science. I think that I had no clue and no preparation for this invasion of science.
I think that war on science, science surrendered immediately and the whole country of science was torn apart among people with very different ideologies and partisan beliefs with strong opinions, with power struggles, with the thirst for power and dominance and conflicts and that’s something that I have not witnessed before and I was not prepared for that and I think that I did my best, but I was close to ridiculously poorly prepared for that.
I think my preparation had been for debates with other scientists with a few scientists who might be knowledgeable in the field or are interested, and sometimes very interested and are fighting for the truth, which is of course evasive for all of us, but I was not prepared to have to fight with all of these powers that had nothing to do with science. That’s something that I feel a complete idiot about.
So let’s be clear what happened here. Dr. Ioannidis became a mini-celebrity by engaging with “politics and media and powers outside of science”, always telling them COVID’s risk was “exaggerated”. Later, after it was clear COVID’s risk was substantial, he said his “biggest mistake” was not that he underestimated the virus, but rather that he had “not prepared to have to fight with all of these powers that had nothing to do with science“. Even though Fox News firebrands Mark Levin and Laura Ingraham would spread blatant COVID misinformation to millions, Dr. Ioannidis bemoaned the influence of these “powers outside of science” as if were merely an innocent observer who played no role in legitimizing and amplifying them.
Of course, it’s not clear who Dr. Ioannidis was talking about when he said he’s had to “fight with all of these powers that had nothing to do with science.” Does he consider himself a crusader in the battle against pandemic misinformation? Were his critics all crass opportunists, motivated by “different ideologies and partisan beliefs with strong opinions, with power struggles, with the thirst for power and dominance and conflicts“? Was Dr. Ioannidis just a pure-of-heart scientist, “fighting for the truth”, totally uninvolved in “politics and media”? Is he a victim in the “war on science?” Should we feel sorry for him?
“I underestimated how much power politics and media and powers outside of science, could have on science.”
In one of those moments that breaks the irony meter, Dr. Ioannidis lodged his complaints about “powers outside of science” in a vanity documentary, one that featured no “debates with other scientists,” but rather him talking and nobody else. In fact, while he is happy to take softball questions lobbed by misinformation-spreading sycophants like Dr. Prasad, I can’t think of a single time that Dr. Ioannidis has taken questions from someone brave enough to remind him of what he actually said in 2020.
COVID-19 has killed thousands of young Americans. This is not just a tragedy for the elderly.
COVID will not be the last pandemic, and we all learned the hard way the incredible damage that politics and media and powers outside of science can cause. As someone who has written extensively about the normalization of the anti-vaccine movement in medicine, I do not disagree with Dr. Ioannidis when he said:
I think that war on science, science surrendered immediately.
While I rightly anticipated a deluge of COVID misinformation, I too greatly underestimated the “war on science.” Never in my wildest dreams did I imagine that prestigious doctors from prestigious medical schools, sheltered from the consequences of their words, would deluge the media and politicians with pro-virus, anti-vaccine misinformation in the middle of a deadly pandemic. That was my biggest mistake and something that I feel a complete idiot about.
Let’s hope future scientists are better prepared than we were for “this invasion of science”. While Dr. Ioannidis and I may feel like complete idiots for underestimating these powers, don’t shed a tear for us. Sure, we have been subject to “vicious attacks”, but we are alive and healthy. We are blessed and fortunate. Save your sympathy for those whose biggest mistake was believing confident scientists on TV who assured them their risk was “completely negligible.”
