It’s bad when doctors spread misinformation.
Dr. Jonathan Storey recently asked me in the comments here:
I was REALLY hoping to get to the root of your medical philosophy.
I replied:
It’s bad when doctors spread misinformation.
Though Dr. Storey rejected my answer, it’s the truth. While he’s welcome to read my neurology textbooks and my book on cognitive biases in medicine to get a broader view, in my writing at SBM, that’s “the root of my medical philosophy”. Though I think every SBM regular would say the same thing, I am not a just stenographer who regurgitates raw data. I aim not just to inform people, but also to warn them- Reader Beware– about the dangers of replacing fact with fiction. Some people don’t get it.
For example, in this moment, with all that’s happening, Dr. Storey was very concerned that I was too mean to Dr. Adam Cifu simply because he profits from a blog that spreads blatant pro-RFK Jr. propaganda. Dr. Storey further anointed himself as my priest and repeatedly demanded that I publicly confess my sins to him. He wrote:
Will you prove yourself capable of making a concession, admitting an error, or publicly changing your mind about something?
Of course, I’ve already done that. I’ve misstated a couple numbers in my articles. Unlike the doctors I discuss, I’ve always acknowledged the error, corrected it, and thanked the person who pointed it out. However, my biggest error, by far, was to continually and repeatedly underestimate the anti-vaccine movement. I also wrote about this error in We Want Them Infected. I said:
I greatly underestimated the strength and durability of anti-vaccine myths. I thought once anti-vaxxers saw their family and friends die of COVID, they would prefer a needle to a coffin. Instead, many doubled down on their denial, claiming COVID is harmless with their last breath…
I also underestimated the appeal of the anti-vaccine movement, which has grown this pandemic, sweeping up previously respectable doctors and scientists in its path. I’ve been writing about the spread of anti-vaccine beliefs in mainstream medicine since the spring of 2021. I started writing after I read an editorial by Drs. Vinay Prasad, Stefan Baral. and Wesley Pegden, a mathematician, titled “COVID Vaccines for Children Should Not Get Emergency Use Authorization,” which was published in the BMJ. Its central thesis was that “severe outcomes or death associated with COVID-19 infection is very low for children, undermining the appropriateness of an emergency use authorization for child COVID-19 vaccines.”
Even though around 450 children had died of COVID and tens of thousands more had been hospitalized by the time the BMJ editorial was published, it neglected to mention any of these sad facts. It also did not mention a Pfizer press release that the vaccine was 100% effective in preventing pediatric COVID in a randomized controlled trial. This trial data was published in The New England Journal of Medicine two months later. The article in the BMJ had but a single reference, about the swine flu debacle of 1976. Aside from this, it was entirely fact-free.
Indeed my first article here at SBM was a rebuttal to Dr. Vinay Prasad’s fact-free article. My response presented loads of data in a neutral manner, and I think it aged quite well, with one exception. At the time, I thought that Dr. Prasad and his co-authors were operating in good faith and could be persuaded by such evidence. I was innocent, foolish, naive, and wrong. Dr. Prasad was launching his career as an anti-vaccine advocate. I should have said so in my first essay.
I recently submitted the final draft of the sequel to WWTI, a book titled Everyone Else is Lying to You, which explains about how doctors who spread COVID misinformation weaponized doubt to rewrite the history of the pandemic and seize power. However, in that book I acknowledge that I again greatly underestimated the anti-vaccine movement. I have been refuting their myths and warning about their dangers for 15 years. I know what these people are like, but I never imagined that dishonest anti-vaxxers with a body count would win.
I would fire ~10,000 people in the CDC
And they are winning. RFK Jr. appears to be headed towards Senate confirmation after Republican Senators, including Dr. Bill Cassidy, placed politics above health. Misinformation doctors like Marty Makary and Jay Bhattacharya are poised to join him. Our public health agencies have gone dormant with no end in sight. Scientists have been silenced, research has been upended, and purges of scientists are promised. Data has been removed for political reasons, and words are being banned from scientific publications. The image below comes straight out of an Orwell novel, but it’s where we are right now. Politics has entered the exam room. Abortion is illegal for countless millions of women and my medical school, caving to political pressure, stopped accepting new young transgender patients.
Worse yet, we are just getting started. Who knows where things will be in 4 years? I have documented medical misinformation not only because resisting pandemic revisionism is valuable in its own right, but also because the threat is ongoing. The same doctors who spent years telling you not to worry about COVID are now telling you not to worry about anything that’s happening now.
Dr. Prasad, for example, says everything is just fine. There was censorship when the Biden administration asked Twitter to de-prioritize a couple of Tweets, but everything the Trump administration is doing is business as normal. There’s nothing to see here. In Dr. Prasad’s fantasy, top CDC officials would be completely safe saying that Trump and Musk are dangerous and incompetent fools, as long as they do so in their “personal capacity”. Those magic words will spare them the wrath of DOGE and Project 2025.
Notice too that even though thousands of meetings have been canceled and researchers silenced, Dr. Prasad is concerned about social media posts. In his world, Tweets and YouTube videos matter more than headlines like this.
Dr. Prasad has also been a cheerleader for RFK Jr., absolving him of responsibility in Samoa, but also future measles outbreaks. Dr. Prasad claims that he is the key to restoring confidence in vaccines
Though Dr. Prasad faked concern about routine vaccines to argue against the COVID vaccine, today he cheers the censorship of vaccine data. Paving the way for RFK Jr. to install anti-vaxx cranks, Dr. Prasad says dedicated scientists at the ACIP are “a mediocre group of scientists” because they objected to his plan to mass infect unvaccinated children with COVID.
Indeed, Dr. Prasad is eager to see mass firings of scientists. Toddlers wore masks after all.
He recognizes that people are going to get hurt and promises more tears to come. He’s right about that. The headlines read White House Preparing Order to Cut Thousands of Federal Health Workers His a wink emoji is someone else’s income and career.
Dr. Prasad was not motivated by evidence and data regarding COVID and he won’t be moving forward either. Though he markets himself as a “physician and medical scholar” who bases his “opinions on a sober assessment of available evidence,” he is a businessman and political actor at this point. He’s chained himself to the RFK-Trump-Musk trifecta and he will cheer and sanewash everything they do. Even as the headlines read, Musk Targets CDC, just watch as Dr. Prasad, an oncologist, interprets the Constitution to explain why Musk’s current role in our government is just fine. It will be interesting to see how Dr. Prasad justifies RFK Jr.’s inevitable attack on the HPV vaccine.
Excessive dogmatism extends to both sides
But the problem isn’t just Dr. Prasad. It’s the cadre of doctors who normalize it all by treating him as a fundamentally rational actor, rather than a propagandist who emotionally manipulates his audience to advance his political objects. Dr. Prasad’s business partners at Sensible Medicine will continue to “debate” him, falsely implying that he arrives at his positions via a reasonable process that should be subject to reasonable discussion. Even if they say they disagree with him, his calls for censorship and purges aren’t a deal-breaker for them. They are OK with it all.
Meanwhile, doctors in the comments here at SBM demanded that I ignore Dr. Prasad’s rageful threats and instead write my 20th article, and once again explain why Dr. Prasad was wrong to treat vaccine side effects as a fate worse they death. They too treat Dr. Prasad and his ilk as fundamentally good-faith, rational actors, who simply have not been presented the data. Why haven’t I shown him? They blamed me for sharing his words and made statements such as:
- Excessive dogmatism extends to both sides.
- I believe he (Prasad) is capable of changing his mind when presented with high-quality data. This makes him quite different than the “quacks” and “antivaxxers” that are profiled on this site as well.
- I think the answer is more data, not more argument.
- The SBM site is performing its own version of “policing” by cherry-picking clips and statements rather than tackling the steel-manned version of potential disagreement.
- The authors here seem very eager to start each article with a littany of self-referencing links that bring up the contrarian’s prior misdeeds and outakes from hundreds of hours of podcast episodes. The majority of articles (I don’t think I’m exaggerating) focus on the “people” rather than their ideas. The “tone” here feels cancel-culture-ish, with there being an eagerness to dismiss one’s entire body of work after making a misstep (or mulitple missteps).
Let’s be clear about my writing here. I thought parents should vaccinate their kids against COVID, and I presented many long lists of studies to back that up. I also thought doctors should communicate accurate information and that it was dangerous to reframe clear misinformation as “independent thinking”. Today, I oppose RFK Jr. and abhor purges and censorship. That’s it. Like I said, it’s bad when doctors spread misinformation.
In contrast, Dr. Prasad spread obviously fake data to mass infect unvaccinated children with a new, mutating virus. Today, he supports RFK Jr. and applauds purges and censorship, often with vulgar, vengeful language designed to inflame and provoke his paying customers. I am blunt, but I never swear at people or call them schoolyard taunts. I never called for anyone to be fired or canceled in any way. I’ve kept my political views mostly to myself. I am not Dr. Prasad’s antagonist because he wanted schools open and I wanted them closed. My critics have been trying in vain for years to find an example of me saying that. Rather, I am his antagonist because I feel doctors should share accurate and thorough information, and he does not.
Yet, according to some doctors, my detailed explanations as to why children should get vaccinated are no different than Dr. Prasad’s vindictive calls to censor and purge scientists, even as that is actually happening today in the real world.
Both sides!
It’s dangerous and absurd to “steel man” Dr. Prasad’s calls to censor and fire scientists or to engage with the fantasy that “more data” will change his mind. I presented him with data all the time. Not once did he engage with it. That’s his perfect right, but it reveals that lack of “high quality data” was never the problem. Doctors spreading misinformation to further their political agenda was always the problem, along with those who claimed this misinformation was just innocent “missteps” without real-world consequences.
We need to be be clear-eyed about the threat moving forward, though it probably too late. The willful blindness of the medical community to the rot within helped bring us to this dangerous moment. As Lysenkoism 2.0 gears up, doctors who say “excessive dogmatism extends to both sides” have fundamentally misunderstood the dangers as well as the entire purpose of SBM. It’s all gone over their head. Dr. Storey had even previously e-mailed the SBM crew and requested:
A small bit of self-reflection on how we are about to end up with RFK Jr leading the HHS.
In reality, those of us who have warned about the anti-vaccine movement for years have nothing to apologize for and aren’t responsible for anything that happens next. We are not to blame for the problems we write about or the words of the doctors we quote. Whatever my sins, there are only two worth confessing. I was too slow to recognize that some people just wanted to taking a wrecking ball to everything, and I was too timid to call out propaganda for what it is.
I should have been doing that from my first article here.