Letter to a Medical Student: There Is No Elite RCT Strike Force
Let’s revisit two of my prior essays.
In one of them, Letter to a Medical Student: There Is No Elite RCT Strike Force, I discussed an article on Sensible Medicine, a monetized blog that spreads blatant anti-vaccine misinformation, titled Death and Isolation During a Pandemic by Ben Knudsen. Mr. Knudsen felt public health officials tried too hard to stop the spread of a deadly virus at the start of the pandemic. He wrote:
It seems as if our hyper-focus on the virus blinded us to the negative implications of certain policies – a calamitous error that will leave a stain on public health’s reputation for decades.
Mr. Knudsen castigated “they” because “they” did not do a randomized controlled-trial (RCT) of hospitalization visitation policies at the start of the pandemic. He felt “they” could and should have done any RCT he merely imagined years later. He wrote:
I imagine that a cluster randomized controlled trial could have provided an answer. This would consist of randomizing hospitals into two groups: ones that allows visitors and others that restrict them. Then, over time, outcomes would be tracked in each group to measure the impact of the policy… There are smart people in positions of power with resources that can design and conduct such studies. Ultimately, they failed us, and we are left without answers and policies that caused significant harm...
I think many of the pandemic policies can be summed up with a simple phrase: “We missed the forest for the trees”. Public health had a myopic focus on stopping the spread of the virus through policies such as limiting visitors in hospitals, masking children, school closures, vaccine mandates, isolating older individuals and by doing so, were unable to see or predict the detrimental harms. Obviously, this doesn’t apply to all policies, but many of them failed to consider what it means to be human.
In my essay, I made it clear there was no distance between myself and Mr. Knudsen about the suffering caused by people dying without their family in 2020. I saw it with my own eyes, and I described it in my essay. However, hospitals were full of people who were kind and compassionate to their dying relative. Those who lost a loved one to COVID should know this. Of course, too many of these kind and compassionate people died of COVID too. Maybe it’s because he didn’t witness this himself, but Mr. Knudsen neglected to inform his readers about any of this.
However, I also argued that anyone who seriously thought about Mr. Knudsen’s imagined RCT for even a nanosecond, something he did not expect his readers to do, would recognize that it would have been both impossible and a waste of resources. There’s no way this RCT actually could have been done, especially considering the most basic RCTs imaginable failed miserably at the time. Mr. Knudsen completely misinformed his readers when he said, “There are smart people in positions of power with resources that can design and conduct such studies.” If the doctors behind Sensible Medicine were in charge of our entire pandemic response, there’s no way they would have pulled off this study. It didn’t even occur to them at the time, and to my knowledge, they did nothing to advance an actual RCT during the pandemic.
It so happens that casually imagining RCTs is the easiest thing in the world. As those who tried will tell you, actually doing them was extremely hard, especially when the virus was spreading unchecked. Those who lost a loved one to COVID should know this too.
Open Letter to a Medical Student Part 2: “It Was Criminal in My Mind”
In my follow-up essay, Open Letter to a Medical Student Part 2: “It Was Criminal in My Mind”, I argued that people who’ve done nothing to advance actual RCTs imagine impossible RCTs years after the fact not to promote medical research, but rather to create doubt and fury about “they”.
My follow-up essay featured many comments from Sensible Medicine readers to illustrate this point. None of them expressed a willingness to enroll in an actual RCT. None of them pushed for more funding for medical research. None of them expressed sympathy for overwhelmed public health officials who had to make difficult decisions on the fly as a new virus rapidly swamped their cities, overflowing hospitals and morgues.
Indeed, we should not forget what happened when the virus was allowed to spread uncontrollably. It wasn’t pretty. Instead of reminding his readers of this tragic history, Mr. Knudsen told them that “public health had a myopic focus on stopping the spread of the virus“, as if that were an absurd goal when hospitals needed forklifts to move corpses in giant trucks.
Certainly, no Sensible Medicine reader who lost a loved one early in the pandemic was comforted by Mr. Knudsen’s disdain towards those who had real-world responsibility at that time. Right or wrong, the difficult decision to ban hospital visitors was made to limit mass illness and death, not out of wanton indifference, as Mr. Knudsen implied. Amazingly, it didn’t occur to Mr. Knudsen that the best way to have to prevented people from dying without their families in 2020, was to have prevented them from dying in the first place. Perhaps those in mourning today might have received a sliver of solace had they been reminded of why tough, painful decisions were made.
However, this is not the goal of Sensible Medicine.
May he be forever riddled with guilt. May he suffer the loss of a loved one in the same manner. May he die alone.
Predictably, instead of gaining insight, Sensible Medicine readers were full of “rage and sorrow”, as one typical commentator put it. This rage was often directed at entire medical profession. One person said:
The medical community is no longer run by humans. Stay away and live longer. There is never any excuse for unethical and down-right rotten behavior in the field of medicine.
Others hinted at retribution:
The powers that be messed up big time during the Covid pandemic. I hope we never forget how death was dehumanized. It was criminal in my mind.
I urge you to read all the comments yourself, particularly from those who lost a loved one to COVID. Sensible Medicine made these damaged people feel much worse, all just to take cheap shots at already beleaguered public health officials– many of them failed to consider what it means to be human, a calamitous error that will leave a stain on public health’s reputation for decades, they failed us, and we are left without answers and policies that caused significant harm. Even though hundreds of public health officials were forced to leave their jobs due to threats and abuse, Sensible Medicine writers are eager to keep pouring fuel on that fire.
However, amidst the anger and mistrust, I can’t stop thinking about one comment in particular. Immediately after the comment calling “the powers that be” criminals, Dr. Adam Cifu, a founder of Sensible Medicine who can be very sensitive to even the slightest hint of indecorous tone when “medical conservatives” have their factual errors corrected, said to Mr. Knudsen:
Wonderful! Thank you so much Ben.
Remember, Mr. Knudsen’s article merely imagined an absurd, obviously impossible RCT. Its whole purpose was to dunk on public health officials and to manipulate, exploit, and provoke people, including vulnerable, grieving people, into making comments like this:
I will never forgive the staff that had become so brainwashed with their own needs to mask up, Mask my Mom up over her O2, which she really didn’t need, yet got sent “home” with. Now I realize the incentives to keep C19 monies moving into these hospitals. To the MD that wouldn’t let her go “home” on her birthday, may he be forever riddled with guilt. May he suffer the loss of a loved one in the same manner. May he die alone.
What’s so wonderful! about all of this?