It is important to hear, consider, and debate these views without ad hominem attacks or animus
On April 27, 2020, Drs. Jeffrey Flier and Vinay Prasad wrote a defense of “independent thinkers, like John Ioannidis” titled Scientists Who Express Different Views on Covid-19 Should Be Heard, Not Demonized. Though the virus was just a few months old, Dr. Ioannidis had already made many confident claims about it. In a paper Coronavirus Disease 2019: The Harms Of Exaggerated Information And Non-Evidence-Based Measures published on March 19th, 2020, he spoke of “exaggerated pandemic estimates” and said:
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.
Then, on April 9, 2020, he 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.
Though this death tally would be surpassed in only 8 days, Drs. Flier and and Prasad weren’t concerned that his absurd predictions might cause some people to underestimate a very dangerous virus. Instead, as hospitals and morgues overflowed, they worried that critics might hurt Dr. Ioannidis’ feelings and deprive him of the platform to which he was entitled. They wrote:
Society faces a risk even more toxic and deadly than Covid-19: that the conduct of science becomes indistinguishable from politics. The tensions between the two policy poles of rapidly and systematically reopening society versus maximizing sheltering in place and social isolation must not be reduced to Republican and Democratic talking points, even as many media outlets promote such simplistic narratives. These critical decisions should be influenced by scientific insights independent of political philosophies and party affiliations. They must be freely debated in the academic world without insult or malice to those with differing views…
At the same time, academics must be able to express a broad range of interpretations and opinions… We think it is important to hear, consider, and debate these views without ad hominem attacks or animus… We believe that the bar to stifling or ignoring academics who are willing to debate their alternative positions in public and in good faith must be very high.
A lot’s happened since then. COVID killed 1.2 million Americans. A president who botched the pandemic, aside from the vaccine he now rejects, is back in power. Scientists are censored and research is threatened. Scientists need bodyguards and vaccine-heroes get accosted at home. Hospitals are sending instructions about what to do if ICE agents show up. Viruses still don’t care about our manners or politics. New threats loom, and old foes like measles and pertussis are poised to return. Cranks are on the verge of power, and many people can’t tell fact from fiction thanks to doctors like Dr. Ioannidis, who is now starring in self-congratulatory movies.
I don’t believe in forgiveness because these pieces of shit are still lying
Meanwhile, Dr. Prasad no longer speaks of the need to debate “views without ad hominem attacks or animus”. Instead, he seeks to provoke and anger his audience with emotionally manipulative, inflammatory language. Watch these two videos, which are normal for Dr. Prasad. He is full of insult and malice to those with differing views.
Yet, even in this dangerous moment, many doctors are totally fine with this. They collaborate with Dr. Prasad and praise his work. His vulgar, vengeful vitriol doesn’t bother them at all. They laugh at it. Did you notice the reaction of the other doctors in the videos. They said nothing when he called people “idiots,” “despicable”, “STUPID“, a “bunch of fools” and “total morons“. They were quiet when he weaponized mental illness to pathologize and humiliate people. They were not bothered by his pro-RFK Jr. propaganda and his blatant anti-vaccine misinformation. They didn’t care that he viciously attacked the exact scientists who needed bodyguards and were stalked at home. Their silence and mirth sent a clear message- this is all fine and OK.
Tone is important
Yet, Dr. Prasad’s defenders, who were often his business partners, pretended to be very concerned about the tone of his critics. Our manners were treated with more gravity than Dr. Prasad’s misinformation. As the Delta variant raged and just months after I started to refute Dr. Prasad’s misinformation here at SBM, suddenly his defenders cared about my decorum. That’s what mattered to them. They wanted to discuss my tone and only my tone. Apparently I “yelled”, though no examples were provided and none ever will be. I am confident in the quality of my arguments, I don’t have paying customers to pander to, and I actually believe in civil discussion. As such, I don’t need to talk like Dr. Prasad.
This is more than just about a few silly Tweets. While tone policing is obviously phony and insincere, it serves several functions that are important to understand not just how we got to this point, but also to make sure we are not distracted by them moving forward.
First, tone policing shields certain doctors from criticism. The Very Serious Doctors who complain about tone, don’t care about tone. It’s an act and performance. Instead, they care about content, and they feign concerns about tone as a cover. Dr. Prasad’s tone police seek to create a safe space where his feelings are given top priority. Anyone who dares to correct his misinformation will invariably be told they are acting inappropriately no matter what they say. By framing their criticisms with regards to civility, the tone police seek to silence critics and make them feel like they are walking on eggshells. If I correct Dr. Prasad’s misinformation, will people say I am attacking him and behaving unprofessionally?
Second, tone-policing is a deliberate distraction. Every moment discussing civility is a moment not spent discussing science and data. Even today as Dr. Prasad cheers mass censorship, purges, and ruined careers- you got to break some eggs to make an omelette– his tone police treat the manners of his critics as the primary value. They claim that it is not “productive” to discuss the gutting of our scientific agencies and that Dr. Prasad should be able to encourage their degredation without the slightest hint of disapproval. Imagine telling someone else how to spend their time or that what’s happening at the NIH is unimportant. Dr. Mark is also rightly pointing out that Dr. Prasad is not personally affected by the policies he promotes. The headline- National Science Foundation Suspends Salary Payments, Leaving Researchers Unable to Pay Their Bills– doesn’t affect Dr. Prasad’s revenue streams. He’s not going to be one of the eggs that gets broken.
Finally, the tone police seek to preemptively discredit anyone who corrects Dr. Prasad’s misinformation, while deliberately avoiding the substance and merits of their arguments. Of course, unlike Dr. Prasad, these critics are honest about the dangers of RFK Jr. Yet, Dr. Prasad’s defenders portrayed them as shrill, unprofessional, and not worth listening to. The message this sends is unmistakable.
As with disingenuous exhortations that certain doctors should not blend politics and medicine, the tone police apply their high standards of decorum only to certain doctors. These certain doctors must be the epitome of decorousness and sobriety with their every utterance. They “cared” about Dr. Nick Mark taking a screenshot of Dr. Prasad’s to make a valid point, but said nothing when Dr. Prasad acted like toddler while taking a screenshot of Dr. Peter Hotez. Imagine their faux outrage if I called someone a “lying piece of shit” or a “fucking moron”.
In contrast, Dr. Prasad and other advocates of mass infection can say whatever they want. Different rules apply to different people. The issue is not just their hypocrisy, it’s how obvious and transparent it all is. Everyone is in on the game. This open hypocrisy send a clear message- the standards we set for those you don’t apply to us and everyone knows it. The hypocrisy is the point. If Dr. Prasad’s defenders want to prove me wrong, they can publicly call on him to stop “yelling.” We all know that will never happen.
But let’s not let anyone succeed in their mission to distract us. Let’s keep focused on where we are today. These are the headlines. Chaos Erupts in US Science as Trump’s Team Declares Freeze on Federal Grants, Alsobrooks Grills Kennedy On Belief That Black Americans Should Get Different Vaccine Schedules, and Trump Removes Anthony Fauci’s Federal Security Detail. We need to be clear-eyed about all this, and looking back, I think those of us who rightly warned of the dangers of medical misinformation should have “yelled” a bit more forcefully actually. And while manners were not the most important thing in 2021 or right now, you’ll never catch me talking like Dr. Prasad or associating myself with someone who does.
Tone is important after all.