Sensible Medicine is a monetized Subtstack that spreads overt anti-vaccine misinformation. Though the doctors who run it claim to be “medical conservatives”, they mostly took a medically radical approach to a new, mutating virus, treating it as an overhyped, predictable entity from the pandemic’s earliest days. As the pandemic progressed, they repeatedly declared it over and encouraged the mass infection of unvaccinated youth by spreading blatantly bogus statistics and treating abnormal lab values after vaccination as a fate worse than death from COVID. A recent article there by Dr. Marty Makary gives us an opportunity to delve into their more pernicious misinformation techniques.
Dr. Makary’s article was ironically titled Does Anyone Still Care About Data? Though it was about new treatments for Alzheimer’s disease, it contained the following paragraph:
America’s Lost Art—the Critical Appraisal of Research
We witnessed similar medical groupthink during Covid. Throughout the pandemic, the medical establishment never talked about Covid’s leading modifiable risk factor—obesity. Instead, they had a singular, albeit important, pharmaceutical solution. They indiscriminately told everyone to get multiple vaccine doses, regardless of whether a person already had high levels of Covid antibodies from natural immunity, or if a healthy young male already had three vaccine doses. During Covid we saw naked allegiance to political figures, regardless of the data. Doctors and the public alike were quick to cite studies to support their ideas, even if the methodological quality would not meet entry criteria for a 7th grade science fair contest. Conversely, research that did not support a forgone conclusion was downplayed, ignored, or censored.
It may not seem that way, but there’s a lot to unpack there. It’s full of misinformation, and every accusation is a confession. Its aim is to create mistrust and resentment, not to inform and educate. Get comfortable and we’ll examine it one piece at a time. I apologize for the fact that:
The amount of energy needed to refute bullshit is an order of magnitude bigger than that needed to produce it.
“We witnessed similar medical groupthink during Covid.”
First note that Dr. Makary wrote in the past tense, about events “during Covid”, as if the virus is gone. Of course, this is false. While hospitals and morgues haven’t been overwhelmed in a long time, SARS-CoV-2 is infecting, injuring, and killing people every day. Dr. Makary, who still discusses the pandemic constantly, has been predicting the end of the pandemic since at least December 2020 when he said, “we may only need to get an additional 20% of the population immunized by February or March to really hit those 70% herd immunity levels.” He’s never wavered from this position. In February 2021 he penned as essay titled “We’ll Have Herd Immunity by April,” and another the next month titled “Herd Immunity Is Near, Despite Fauci’s Denial“. In May 2021, he said he was right, claiming that “most of the country is at herd immunity”. He wrote articles in the NY Post that month titled, “Risk of COVID is Now Very Low — It’s Time to Stop Living in Fear: Doctor” and “Don’t Buy the Fearmongering: The COVID-19 Threat is Waning“. Dr. Makary later referred to the Omicron variant as “omi-cold” and “nature’s vaccine.” Anyone who cared about data knew that Dr. Makary was wrong about all this.
Does anyone still care about data?
Dr. Makary also sets the stage by signaling that he’s a brave, maverick doctor, while his critics are sheep, incapable of independent thought, just “groupthink”. There’s a grain of truth here. Though we at SBM are not afraid to disagree with each other in public, we all have biases, including in-group loyalty. It’s often trivial to see such bias in others, though nearly impossible to see in oneself. As such, it’s both easy and dangerous to imagine that only those who disagree with you are afflicted by groupthink, while you are perfect beacon of independent, rational thought- along with everyone who agrees with you.
Though the doctors behind Sensible Medicine portray themselves as immune to “groupthink”, they largely marched in lockstep during the pandemic, objecting to most measures to control COVID and minimize its dangers. To pick one example amongst many, they were united in their belief that the pandemic was ending in early 2021, and that ridicule was an appropriate response to anyone who disagreed. Their sarcastic mockery occurred even during the pandemic’s deadliest month, January 2021, while over 3,000 Americans were dying of COVID daily, and even on what turned out to be the literal peak of the deadliest wave, January 16, 2021. Over 700,000 Americans have since died of COVID.
Medical groupthink during COVID
When herd immunity failed to arrive, Sensible Medicine doctors only further encouraged groupthink by repeatedly shaming and pathologizing the small number of nonconformists who take measures to avoid repeated infections. When the Omicron variant emerged, Dr. Makary was fearful of a “wave of fear”, saying it could fuel a “pandemic of lunacy”. Dr. Prasad, who started the pandemic saying personal attacks were “worse than COVID”, similarly weaponized mental illness to stigmatize cautious people. In June 2023 he said:
Medhi Hasan is an idiot. Of course we have to learn to live with covid. Everyone is living with it. That is precisely what happened. No one gives a shit about COVID anymore & no one sane is taking any precautions. It even bores me & I know fully how wrong the establishment was.
Talk about groupthink.
Dr. Prasad, who also still discusses the pandemic constantly, even formalized his dedication to groupthink by asking his followers to publicly pledge to refuse more COVID vaccines. A request for a written, public display of conformity is a classic influencer technique, described by Robert Cialdini who said:
Commitments are most effective in changing a person’s self-image and future behavior when they are active, public, and effortful.
Medical groupthink during COVID
“Throughout the pandemic, the medical establishment never talked about Covid’s leading modifiable risk factor—obesity.”
Next, Dr. Makary signals that he’s an outsider, and therefore not responsible for our pandemic disaster in any way. Parroting Dr. Prasad, who said “I know fully how wrong the establishment was”, Dr. Makary also wants his audience to believe he’s not part of the “establishment”. I’m with you, not them.
Talk about groupthink.
Of course, this is false. Dr. Makary is the Mark Ravitch Chair in Gastrointestinal Surgery at Johns Hopkins School of Medicine, and teaches public health policy as Professor of Surgery and Public Health at the Johns Hopkins Bloomberg School of Public Health. In 2018, he was elected to the National Academy of Medicine. He was well-known before the pandemic, particularly for his claim, debunked by Dr. Prasad, that medical error is the third leading cause of death. He has 234,000 Twitter followers, and was a ubiquitous media presence this pandemic. He was on Fox News hundreds of times, declaring the end of the pandemic and spreading anti-vaccine misinformation. According to an article from Media Matters from December 2021 about these appearances:
Makary has been described as “a darling of the anti-vaxxers” for contradicting current vaccine consensus among medical professionals. Makary has also written that there is “no compelling case” for vaccinating “healthy” children and claimed that he is “not aware of a single healthy child in the U.S. who has died of COVID-19 to date” – discounting all cases that involved disabled children with underlying health conditions.
Despite Makary making numerous false predictions (saying, for example, that the United States would reach herd immunity by April) and being called out by other public experts for downplaying the risk of infectious disease, Fox regularly invited him back on-air in 2021 to undermine public health efforts:
- In March on The Story with Martha MacCallum, Makary predicted there was low risk of new variants causing COVID-19 surges, and on Your World with Neil Cavuto, he accused public health experts of “cry[ing] wolf” over the threat of new variants.
- In June on America Reports, Makary went so far as to complain that discussion of new variants is “fearmongering” to “manipulate people to get vaccinated,” saying, “I’m for vaccines, but this has turned into a tool to try to coax people into it.”
- In June on Special Report, Makary claimed it’s time to “move on and live a normal life” comparing COVID-19 cases to influenza: “right now we’re about at 150th the daily cases of a regular seasonal flu in the middle of that flu season. So people have a distorted perception of risk.” According to Makary’s own employer, Johns Hopkins, COVID-19 has a mortality rate 10 times higher that of the flu.
- On Your World with Neil Cavuto in November, Makary undermined efforts to vaccinate children, saying kids with natural immunity should not be vaccinated. He went on to fearmonger about potential side effects of vaccinations.
- On Fox News Primetime in November, Makary claimed to be pro-vaccine but said he stands against “obsolete” vaccine mandates, especially for children. Makary falsely asserted that “public health officials have brushed under the rug the fact that kids have died from the vaccine, it’s rare” citing myocarditis occurrences in young boys. (However the real risk of myocarditis is from COVID-19, not vaccines, and most people who develop myocarditis recover quickly.)
Dr. Markary was also the editor of Medpage Today and spread his misinformation message in the Wall Street Journal, New York Post, and Washington Post. He testified before Congress on more than one occasion and had private audiences with Republican congressional doctors. He was the COVID advisor to the Governor of Virginia. You can even hire him to speak for $20,000-$30,000.
He is definition of the medical establishment.
Medical groupthink from the medical establishment
Having falsely told his readers he’s not part of the “establishment”, Dr. Makary then claims they “never talked about Covid’s leading modifiable risk factor—obesity”. Of course, this is false. The CDC listed “Severe obesity (body mass index [BMI] of 40 or higher)” as a risk factor for severe COVID as early as April 2, 2020 and they later published studies on the subject got that widespread media attention. They said:
As clinicians develop care plans for COVID-19 patients, they should consider the risk for severe outcomes in patients with higher BMIs, especially for those with severe obesity.
They were not alone. As early as March 2020, Dr. Anthony Fauci said:
It’s so clear that the overwhelming weight of serious disease and mortality is on those who are elderly and those with a serious comorbidity: heart disease, chronic lung disease, diabetes, obesity, respiratory difficulties.
He elaborated in 2021, saying:
The other thing I believe, is that obese people, particularly morbidly obese people, have a much higher rate of the other underlying comorbidities, which get a serious outcome. That’s diabetes, hypertension, heart disease—the incidents in a morbidly obese person of those other diseases is much higher than the general population.
Similarly, Dr. Francis Collins, the former director of the NIH, said in June 2020:
We also know that chronic illnesses play a role in who’s going to have a severe case. Certainly hypertension and diabetes and obesity are in there as well.
In fact, a simple Google search returned around 100 articles by the “establishment” on obesity and COVID from throughout the pandemic. My university published an article on April 16, 2020 titled “The New York Times: Obesity Associated with Severe Coronavirus Disease, Especially in Young Adults“. One from Dr. Makary’s university on June 1, 2020 was titled “Obesity a Major Risk Factor for COVID-19 Hospitalizations.” Harvard, Yale, Stanford, UCSF, The University of Chicago, and dozens of other medical schools wrote about obesity and COVID. So did the American Medical Association, the American Academy of Pediatrics, the American Heart Association, the Endocrine Society, and numerous other medical organizations. Major newspapers discussed it. I also discussed obesity as a risk factor for severe disease in children, noting that nearly all who perished from the virus were robbed of decades of life. It’s hard to find examples of the “establishment” who completely ignored the relationship between obesity and COVID
“Throughout the pandemic, the medical establishment never talked about Covid’s leading modifiable risk factor—obesity.”
Maybe the “establishment” should have talked about obesity more- Dr. Makary has just seven Tweets on the topic, the first from December 2020, the last from May 2022 -but it wasn’t exactly a top classified secret that it posed a risk for severe COVID. Nonetheless, Dr. Makary imagines that a large number of obese people were totally unaware of this risk, and that many of them could have have lost weight, if only the “establishment” had been more vocal on the topic. One overweight friend reacted to Dr. Makary by telling me:
Do people really think fat people don’t know they are fat and would instantly be thin just because some doctors says, “Oh, you should lose weight”?
People do actually think that, and it’s absurd. Many of my patients are overweight. They are not ignorant of obesity’s health risks, and nearly all tried everything for years to lose weight. While weight-loss is crucial and possible for many people, it’s not easy or instant for anyone, and a bit more encouragement from the “establishment” was not the secret sauce anyone was missing. Protecting obese people, who could not lose weight instantly three years ago is one reason we went to such lengths to control the the virus. 42% of Americans are obese, their lives are not expendable, and the “establishment” could not have reversed obesity on a dime in March 2020. If Dr. Makary disagrees, then he should explain why he failed to cure obesity in Virginia during his stint as that state’s COVID advisor.
And let’s pause and look what Dr. Makary has communicated in just two short sentences. He’s signaled that COVID is over, denigrated his critics as the “establishment”, and claimed they were incapable of independent thought. He absurdly implied that obese people were ignorant of their condition, and that “Covid’s leading modifiable risk factor” could have been drastically improved if not for the apathy of the “establishment”. Moreover, he disrespected his readers by spreading easily-refutable misinformation, claiming that “Throughout the pandemic, the medical establishment never talked about Covid’s leading modifiable risk factor—obesity.” Throughout the pandemic! Never! Either Dr. Makary didn’t bother with basic fact checking or he didn’t care that he was spreading a blatant falsity. However, his goal wasn’t to communicate accurate information. Like most Sensible Medicine writers, his aim was to trigger anger and groupthink.
Throughout the pandemic! Never!
Of course, legitimate criticisms of the “establishment” are necessary and vital, and we here at SBM don’t shy away from criticizing medical boards, regulatory agencies, academic fraud, problematic drug approvals, as well as many individual “leaders” of American medicine. Some of the best work in this area comes from those truly outside the medical establishment, such as the Death Panel Podcast. However, while mistakes were made and some bad faith actors purposefully undermined all efforts to contain the virus, the vast majority of public health officials were people you’ve never heard of, working on the ground, doing the best they could to save lives in an unprecedented situation. Whatever their errors, it wasn’t easy to have real-world responsibility during the pandemic. As the bodies piled up, tough decisions had to be made in real-time with incomplete information. The right answers weren’t always obvious. This was everyone’s first pandemic and SARS-CoV-2 was a new virus, after all.
Moreover, public health agencies hadn’t been showered with cash and resources prior to the pandemic. Quite the opposite, actually. Public health officials couldn’t have done everything that’s now being demanded of them. When morgues were overflowing, they didn’t have the resources to launch a nationwide obesity awareness campaign.
However, asinine claims that the “establishment” could have tackled obesity in March 2020 have a broader purpose. They are part of a larger movement to rewrite history and minimize the enormous challenges the “establishment” faced at the pandemic’s start. Of course, this is just another way to minimize COVID itself. Some influential people want everyone to forget that refrigerated trucks were needed to store dead bodies outside my hospital. Doctors who greatly underestimated the virus at the start and who never treated COVID patients themselves, now seek to absolve their calamitous errors by blaming the “establishment” for not fixing every societal ill in March 2020. It’s no big deal that I said we’d have herd immunity by April. People just needed to stop being fat, and the establishment is to blame for that, not me. Unsurprisingly, the original COVID minimizer Dr. John Ioannidis, pioneered this deflection technique in 2021, creating a list of what “really caused” millions of COVID deaths. In 2023, Dr. Makary parroted his exact language, calling obesity a “modifiable risk factor” to similarly imply it “really caused” many COVID deaths.
Talk about groupthink.
Dr. John Ioannidis on what “really caused” COVID deaths
With the “establishment” and obese people there to take the blame, these doctors then seek to convince us that all measures to control the virus were an overreaction, a position many of them formulated in March 2020, when they thought fewer than 40,000 Americans would die. For example, demonstrating yet more groupthink by parroting the doctors behind the Great Barrington Declaration, Dr. Prasad said in March 2022:
Masks, distance, lockdown, test often don’t work, if they work, only delay the inevitable great harm.
Of course it’s unambiguously good that measures to control the virus delayed the inevitable and allowed countless millions of people to avoid it until after they were vaccinated and medical care had improved. The vaccines aren’t perfect, but a fully vaccinated person who contracts COVID today has much better odds of a good outcome than someone who contracted it in April 2020 when hospitals were deluged and we had no idea how to treat it. According to one modeling study:
From December 2020 through November 2022, we estimate that the COVID-19 vaccination program in the U.S. prevented more than 18.5 million additional hospitalizations and 3.2 million additional deaths.
An obesity awareness campaign wouldn’t have had this impact.
In lieu of legitimate criticisms of the “establishment”, Sensible Medicine makes blatantly false statements about them and makes very difficult, even impossible tasks sound trivial. They want their readers to believe the “establishment” could have done nearly anything, but they were too stupid or apathetic to do many easy and obvious things. This too has a broader purpose. Their main goal is to get people to stop trusting the public health “establishment”, and you don’t have to take my word for it.
Unfortunately, Sensible Medicine is very successful in getting their audience to stop trusting the public health “establishment.” One commentator on Dr. Makary’s article said:
So sad. Medical community has gone crazy – and evil – since covid pandemic emerged.
This unbridled rage is par for the course for the grossly misinformed readers of Sensible Medicine, and that really matters. I encourage you to read the comments on an article titled “A Public Health Worker Looks Back at the Pandemic and How We Reacted to It,” by Matthew Brignall, a public health worker who was brave enough to work on the ground during during the pandemic and even braver to share his experience on Sensible Medicine. He wrote:
State and local health policies suppressed the spread of COVID-19 until we could develop an effective vaccine and get it into the arms of the most vulnerable people.
His reward for making sensible statements on Sensible Medicine was hundreds of comments calling him a “biofascist scum” and someone who helped “usher in tyranny around the globe.” Dr. Adam Cifu, a founder of Sensible Medicine, knew his readership and tried to prepare him for the backlash, but even Mr. Brignall was taken aback by the fury and groupthink, saying:
To be fair, Adam warned me, and I chose not to turn off the comments. But yeah, that shit was a cesspool. I think it is instructive to see how quickly the internet goes to lynch mob when the opinion is challenging.
Indeed, Sensible Medicine excels at creating a cesspool of resentment. I previously discussed an article there that lambasted the “establishment” for not doing an absurd, utterly impossible randomized-controlled trial (RCT) of hospital visitation policies at the pandemic’s start. Predictably, their readers, consumed by groupthink, responded not by agreeing to volunteer for future RCTs, but by sharing their fury and retribution fantasies against the “establishment”. “It was a purposeful dictate designed to wreck humanity,” said one. “These people need to be held accountable”, said another. “It was criminal in my mind”, said another. Another said:
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.
Charming stuff. Meanwhile, Dr. Cifu, who was very concerned about the “tone” of those who corrected the factual errors of his Sensible Medicine colleagues, also appeared in the comments and said to its author, “Wonderful. Thank you so much Ben“.
All of this anger and mistrust had consequences in the real-world, and none of it was “wonderful”. RCTs require volunteers who trust clinical trialists, AKA the “establishment”. I was in a vaccine RCT and because I actually want them to be successful, I always spoke positively about them. In my first article this pandemic, I discussed my experience and said:
Having argued for years that vaccines are properly tested, I jumped at the chance to participate in a vaccine trial myself. I’ve always believed that people who participate in medical research are doing a noble thing. If no one volunteered for such research, medicine would never advance.
In contrast, I don’t recall a Sensible Medicine doctor ever promoting an actual RCT or encouraging their audience to enroll in one. However, advancing actual RCTs is not their goal, which is a shame. Some very simple RCTs couldn’t even get off the ground due to low enrollment. It turns out that actually doing an RCT is a lot harder than writing “do an RCT”, and podcasting doctors who excoriated the “establishment” for not doing RCTs of everything, made it harder for anyone to do an RCT of anything.
Beyond this, many public health officials, AKA the “establishment”, were threatened, harassed, and attacked during the pandemic, leading many to quit. One public healthcare worker sent me the following message:
To shield themselves from similar vitriol, Sensible Medicine doctors falsely portray themselves as outsiders, wryly observing the “groupthink” of the “establishment” from a distance. Though they absolutely are part of the “establishment”, they don’t consider it their job to solve obesity, run an RCT, or seemingly do much of anything, besides commenting from the sidelines, blaming others for not doing everything they imagined. “If only they’d listened to me, things would have been just fine,” they say in articles that should be titled “What I Would Have Done“.
Of course, none of us have to wonder what we would have done this pandemic. What you actually did is exactly what you would have done.
“Instead, they had a singular, albeit important, pharmaceutical solution.”
Having poisoned the well against the “establishment”, Dr. Makary then pivots to his standard anti-vaccine blather. According to Dr. Makary, the brainless drones who chose not to cure obesity, had a “singular” focus on vaccines. This is partially true. Dr. Fauci, an avid jogger himself, encouraged exercise in the summer of 2020. He also took a medically conservative approach to the vaccines, saying in February 2021:
But even if you’re one of the lucky few to have gotten a Covid-19 shot, it will be important to continue wearing a face covering until researchers can determine whether the vaccines prevent people from spreading the virus to others who aren’t vaccinated.
However, for over a year, the “establishment” has abandoned all measures to control the virus, aside from their singular focus on vaccines. Put another way, the “establishment” adopted essentially all the positions of Sensible Medicine doctors, who are, of course, the “establishment”. Indeed, it was the doctors at Sensible Medicine who had a “singular” focus on vaccines, claiming they obviated other measures to contain the virus almost immediately after they came out. Dr. Markary said in March 2021:
If anyone hears of a person hospitalized or dead from Covid-19 after full vaccination, please let me know. The data show that vaccines confer near perfect protection against death and hospitalization from Covid. Can’t we be honest about that?
Dr. John Mandrola said in March 2021, “The pandemic is essentially done….The vaccine squelches severe cases.” Later that year he said, “Have the vaccines not transformed SARSCOV2 into just another regular respiratory virus?” Though he later said such comments were the “worst misinformation” Dr. Prasad said in January 2021:
You will be less infectious, dramatically less infectious, less of a threat to others after vaccination. Of course, no surprise, that’s why we’re vaccinating, right?
In February 2021, just after the deadliest month of the pandemic, Dr. Prasad mocked the New York Times for suggesting that vaccines alone might not end the pandemic. “It was just completely off, and just another squeeze of fear,” he said. That same month he said, “we know the vaccine is 100% effective against protecting against bad outcomes for grandparent,” and in May that year, he claimed:
For somebody who’s already been fully vaccinated, they can wear the mask out of solidarity or in a symbolic sense, but their wearing a mask indoors is not benefiting anyone else. There’s an infinitesimally low probability of even having an infection that can be detected on a PCR test, let alone being able to spread it to someone.
This was pure groupthink from establishment doctors who rejected medical conservatism and now blame the “establishment” for their words. Thankfully, I avoided this groupthink and rejected a singular focus on vaccines. In April 2021, I said,
Im very very optimistic vaccines will cut transmission of disease. I’m not certain of it. This is why I wear a mask still in public and when treating covid patients.
A singular focus on vaccines
Notice too how Dr. Makary calls vaccines a “pharmaceutical solution”. While this obviously isn’t wrong, this framing was a conscious choice to spread fear and doubt. If you think I’m overstating the case, consider the subtitle of an essay of his that spread misinformation about the COVID vaccine in pregnancy:
The Agency (CDC) did exactly what big Pharma wanted, using groupthink instead of insisting on data for their recommendations.
That sentence could appear on anti-antivaccine site about any vaccine. It’s standard anti-vaxx balderdash. It’s no secret that many Americans distrust the pharmaceutical industry, often with good reason. However, by telling people vaccines = pharma, Dr. Makary sought to reinforce this negative association for his readers. It worked. One of his commentators said:
Pharma won’t allow lifestyle change to trump sales, so we can’t depend on them. Many health organizations make $ only when there are patients, so we won’t see preventatives from whole organizations. Thank god for individuals who ignore the business model and want to help individual patients.
Dr. Makary could have said vaccines are an “immunological solution” and presented the copious evidence they reduced grave outcomes. But having greatly oversold them in 2021, Sensible Medicine doctors are loathe to frame them in a positive light today. Of course, by decreasing hospitalizations, COVID vaccines saved the healthcare system enormous sums of money, including a large amount spent on pharmaceutical products. Those of us are actually opposed to mere “pharmaceutical solutions” to COVID, embraced vaccines while being honest about their flaws. At least Dr. Makary conceded vaccines are “important”.
“They indiscriminately told everyone to get multiple vaccine doses, regardless of whether a person already had high levels of Covid antibodies from natural immunity, or if a healthy young male already had three vaccine doses.”
Dr. Makary then claims “they indiscriminately told everyone to get multiple vaccine doses”. Of course, this is false. You may feel the “establishment” should have left more unvaccinated people vulnerable to the virus, but they didn’t come to their policies on a whim. The Advisory Committee on Immunization Practices (ACIP) had multiple lengthy, public meetings to review the data and discuss every vaccine dose. In fact, the “establishment” disagreed on boosters initially. In September 2021, CDC director Dr. Rochelle Walensky overruled the ACIP, which had voted 9-6 against suggesting boosters to health care workers and other frontline workers. Several vaccine regulators voiced their opposition in the Washington Post and ultimately resigned in protest, something Dr. Makary celebrated on social media.
So much for groupthink.
Moreover, many people felt the “establishment” dragged its feet in authorizing pediatric vaccines. There was a real price to paid for “precaution”. Of course, unless the “establishment” ran a massive RCT for every tweek to the vaccine, Sensible Medicine doctors would always accuse them of acting “indiscriminately”, as if only the vaccine posed a threat, never the virus.
The belief that the virus was essentially harmless for all but the most vulnerable people may explain why Sensible Medicine doctors indiscriminately told everyone to contract it multiple times. Even though no RCT shows this is safe, Dr. Prasad said in 2023, “Repeat infections are inevitable. More the longer you live. Nothing can be done about it.” Dr. Cifu expressed the exact same sentiment in May 2022, saying:
We now need to accept that this is here to get infected with again and again.
Talk about groupthink.
Notice as well that Dr. Makary views “antibodies from natural immunity” as a valid reason to forego vaccination. Sounding like a pre-pandemic anti-vaxxer gushing over measles, Dr. Makary acted like cheerleader for SARS-CoV-2 much of the pandemic – “natural immunity wins again“- claiming that vaccines and “natural immunity” would usher in herd immunity by April 2021. Even after this prediction failed miserably and immune-evading variants arrived, he continued to lament that “policymakers” did not glorify “natural immunity”. “It’s okay to have an incorrect scientific hypothesis. But when new data proves it wrong, you have to adapt”, he wrote, scolding people who didn’t claim herd immunity arrived in May 2021.
Of course, the power of “natural immunity” was that it killed over a million Americans. “Natural immunity” injured millions more, and isn’t as powerful as hoped for these survivors. Moreover, there is evidence that vaccination after infection was beneficial at limiting hospital admissions and severe disease. Sensible Medicine readers won’t know this.
Beyond this, Dr. Makary implies there’s something nefarious about “multiple vaccine doses”, though he doesn’t say what that is. Of course, most vaccines require multiple doses. Children receive four polio vaccinations by the time they are six. They receive five doses of the DTaP vaccine by this age. The flu vaccine is given annually. Does Dr. Makary blame the “establishment” for this?
Though it would have been great, there was never any guarantee that the first two COVID doses would provide lifelong protection against a new, mutating virus. However, even if the “establishment” ended up suggesting a vaccine dose to someone who didn’t need it, they had to make recommendations with less-than-perfect data in the middle of a rapidly changing pandemic. That’s medicine. It’s a fantasy to imagine that we will always have a tidy RCT to resolve every question. The risks will not always be perfectly known and letting children, especially unvaccinated ones, repeatedly get COVID is an example of an unknown risk.
Nonetheless, it’s true that some people got a vaccine dose they probably didn’t need. However, Dr. Makary didn’t explain why, in a pandemic where 1.1 million Americans died and millions more were injured, this was such a cause for concern. Why was it really so disastrous if a healthy young male chose to get a 4th dose? I’ve discussed the risks of the vaccine many times previously, and while tragic, catastrophic reactions, including deaths, have occurred, they are literally less than one in a million events. In contrast, a study from May 2022, estimated that nearly 319,000 deaths could have been prevented if all American adults had gotten vaccinated. Dr. Makary did not bemoan the fate of the people who suffered needlessly because they refused a vaccine dose they did need- including the first booster and bivalent booster– and the deceased are not here to extol the power of “natural immunity”.
The power of “natural immunity”
“During Covid we saw naked allegiance to political figures, regardless of the data.”
Dr. Makary was not wrong about this, nor was he the only Sensible Medicine doctor to portray himself as floating above the political fray. Dr. Prasad and Dr. Jeffrey Flier shared a similar concern at the start of the pandemic in an essay titled “Scientists Who Express Different Views on Covid-19 Should be Heard, not Demonized“. This authors said they were “concerned with personal attacks and general disparaging comments” and concluded.
Society faces a risk even more toxic and deadly than Covid-19: that the conduct of science becomes indistinguishable from politics.
In an article titled “Politics and Medicine is a Bad Idea” Dr. Mandrola similarly warned of the dangers of mixing politics and medicine. He said, “our medical training provides us no expertise on policy”. “There are many downsides when healthcare professionals overstep our expertise.” he added.
Talk about groupthink.
Dr. Mandrola ended his essay by saying:
We should remain like a neutral judge. Always. The people can decide the best policy.
Despite this clear, unambiguous conclusion, Dr. Mandrola did not mention his Sensible Medicine colleague Dr. Prasad. This is not for lack of opportunities. Dr. Prasad, an adult oncologist whose medical training provided him no expertise on policy, repeatedly compared school closures to the Iraq War and wrote over 50 pugilistic Tweets on the evils of teachers unions. When schools in Philadelphia closed a Friday due to poor air quality from forest fires, he said:
I really hope that in return for your repeated failure to do what is right for children we move to a voucher system that crushes your failed district and destroys your union system that always places adult interests over children.
The schools reopened Monday.
Dr. Prasad also frequently villainized “Democratic cities”, “left wing politics” “NYTimes reporters” “liberal cities” and “Fauci” . One of many emotive Tweets attacking “dems” said:
Dems have become the corporatist party. Pfizer basically writes EUA orders based on mice data. At the worst moment of the pandemic Dems abandoned kids, esp poor minority kids to side with teachers unions. Instead of hearing criticism, they preferred to censor Twitter & YouTube.
Though I won’t say that his behavior was “more toxic and deadly than Covid-19”, Dr. Prasad also revelled in demonizing scientists who expressed different views. He said that RFK Jr, a presidential candidate and anti-vaccine crank with a body count, would “destroy”, “flatten” and “obliterate” Dr. Peter Hotez, a highly-respected vaccine scientist who received anti-semitic death threats and was harassed at home for wisely refusing to perform a verbal joust with RFK Jr. on a podcast.
Talk about the conduct of science becoming indistinguishable from politics.
The conduct of science becomes indistinguishable from politics.
RFK Jr. was not the only anti-vaccine politician to receive praise from Dr. Prasad. In May 2023 he said that:
DeSantis Florida had the best COVID-19 policy in the United States. Balancing competing risks and freedom.
The data argues otherwise. A recent article titled The Steep Cost of Ron DeSantis’s Vaccine Turnabout shows how anti-vaccine doctors with naked allegiance to political figures ignored the data, costing thousands of young Floridians their lives. It said:
At the same time, though, the governor was embracing more extreme views, including those of Dr. Scott W. Atlas, a Stanford neuroradiologist with no expertise in infectious diseases. Dr. Atlas was a frequent commentator on Fox News when Mr. Trump named him to his Covid task force in August 2020.
Both he and Dr. Bhattacharya argued that people who were not at risk of severe consequences should not face Covid restrictions. If they were infected, they would develop natural immunity, which would eventually build up in the population and cause the virus to fade away, they said….
Dr. Atlas, however, argued that the virus was not dangerous to an overwhelming majority of Americans. Both he and Dr. Bhattacharya said the Covid death rate for everyone under 70 was very low. Dr. Atlas claimed that children had “virtually zero” risk of death. Neither man responded to requests for comment…
While Florida was an early leader in the share of over-65 residents who were vaccinated, it had fallen to the middle of the pack by the end of July 2021. When it came to younger residents, Florida lagged behind the national average in every age group.
That left the state particularly vulnerable when the Delta variant hit that month. Floridians died at a higher rate, adjusted for age, than residents of almost any other state during the Delta wave, according to the Times analysis. With less than 7 percent of the nation’s population, Florida accounted for 14 percent of deaths between the start of July and the end of October.
Of the 23,000 Floridians who died, 9,000 were younger than 65. Despite the governor’s insistence at the time that “our entire vulnerable population has basically been vaccinated,” a vast majority of the 23,000 were either unvaccinated or had not yet completed the two-dose regimen.
The two images below, just six weeks apart, summarize the largely preventable tragedy well.
DeSantis Florida had the best COVID-19 policy in the United States
The unchecked spread of the virus also meant many schools couldn’t stay open in Florida. “It’s just not sustainable when you don’t have the people to run the school,” said one principal. Another superintendent said during the Delta wave:
COVID numbers are currently on the climb and having an impact on students, teachers, and on the support staff on whom we rely so heavily – particularly our food service workers and bus drivers.
This is the state and governor that Dr. Prasad said had “best COVID-19 policy in the United States”.
Dr. Prasad even defended the Surgeon General of Florida, Dr. Joseph Ladapo, saying his critics of his anti-vaccine data fraud were “stupid.” “Ladapo is closer to correct than his critics”, he said about a doctor who altered data to make the vaccine appear more dangerous than the virus.
Talk about naked allegiance to political figures, regardless of the data.
Naked allegiance to political figures regardless of the data
“Doctors and the public alike were quick to cite studies to support their ideas, even if the methodological quality would not meet entry criteria for a 7th grade science fair contest.”
Dr. Makary then laments that “Doctors and the public alike were quick to cite studies to support their ideas, even if the methodological quality would not meet entry criteria for a 7th grade science fair contest.” Again, he’s not wrong. Many bad studies were published this pandemic, and Sensible Medicine doctors were eager to amplify those that supported their ideas. For example, Drs. Prasad and Makary both promoted a horrible, retracted anti-mask study written by anti-vaccine activists, and Dr. Makary’s enthusiastic Tweet about it remains uncorrected to this day. He said:
Kids need fresh air! A new JAMA study describes consequences of elevated carbon dioxide levels in kids and hypercapnia from inhaled air from the dead space a mask creates.
Dr. Makary did more than amplify bad studies that supported his ideas, he authored one himself. In an editorial tilted “Think Twice Before Giving the COVID Vax to Healthy Kids“, Dr, Makary said:
In reviewing the medical literature and news reports, and in talking to pediatricians across the country, I am not aware of a single healthy child in the U.S. who has died of COVID-19 to date. My research team at Johns Hopkins partnered with FAIR health to study pediatric COVID-19 deaths using approximately half of the nation’s health insurance data. We found that 100% of pediatric COVID-19 deaths were in children with a pre-existing condition, solidifying the case to vaccinate any child with a comorbidity.
Dr. Makary’s report was titled “Risk Factors for COVID-19 Mortality among Privately Insured Patients: A Claims Data Analysis”. It was published as a “white paper,” not in a medical journal. Though he claimed it was a study of “pediatric COVID-19 deaths”, the words “child,” “children,” and “pediatrics” do not appear in it, though there is a discussion of Alzheimer’s disease in relation to COVID. The paper reported on 2,753 people who died of COVID from April 1, 2020, through August 31, 2020. Of these, 0.11% deaths occurred in children under 18-years. This means Dr. Makary’s supposed study of “pediatric COVID-19 deaths” reported on just three deceased children. It presented no data about them beyond noting they were under age 18 years and had some underlying condition.
Would a 7th-grader at a science fair use a sample size of three to claim that zero healthy children had died of COVID in the entire country? If they did, they’d be wrong. Sadly, healthy children had died of COVID when Dr. Makary made his false claim, something a 7th grader could have easily discovered with a simple Google search.
Of course, the lives of vulnerable children are not less valuable than healthy ones.
“Conversely, research that did not support a forgone conclusion was downplayed, ignored, or censored”.
Dr. Makary was not wrong to say that “research that did not support a forgone conclusion was downplayed, ignored”. I’ve written previously (here, here, and here) on how Sensible Medicine writers cherry-pick information to minimize COVID’s impact on children, as well as to fear monger about the vaccine and hide its benefits. I previously said
If ten data points are needed to understand the risks and benefits of the vaccine, they cherry pick the three that support their position.
Indeed, most Sensible Medicine doctors started with the conclusion that unvaccinated children should contract COVID, and worked backwards to selectively present the “evidence” only that supported their mass infection. To my knowledge, Dr. Makary has never shared any of the dozens of studies showing the vaccine has helped limit rare, but grave harms in children. Sensible Medicine doctors pretend these studies do not exist.
Dr. Makary ends with conspiracies, though he does not say which research was “censored”. In fact, his paragraph didn’t contain a single link to support any of his claims. However, in March 2022, he complained that the “establishment” rejected his findings on obesity and COVID. He said:
Unfortunately a lot of medical journals were heavily curating the establishment narrative. Our Hopkins study showing obesity was a major risk factor for Covid mortality was ready for publication in July 2020 but was rejected at 7 medical journals over a 1.5 year period.
What does Dr. Makary think the “establishment” has to gain by covering up a link between obesity and severe COVID. Why does he think the editors of multiple medical journals agree to suppress such an important finding?
If indeed the “establishment” did seek to “curate” medical journals to hide this link, they did a poor job of it. In addition to the articles I linked to previously, on April 1, 2020 the editors of the journal Obesity wrote an editorial titled “COVID 19 and the Patient with Obesity – The Editors Speak Out” in which they said:
Persons with obesity around the world are already at high risk for severe complications of COVID-19, by virtue of the increased risk of the chronic diseases that obesity drives.
The New York Times wrote an article in April 2020 titled “Obesity Linked to Severe Coronavirus Disease, Especially for Younger Patients” that referenced research at NYU. It said:
One of the largest U.S. studies to identify obesity as a prominent risk factor analyzed data from more than 4,000 Covid-19 patients who sought care at NYU Langone Health between March 1 and April 2.
It also discussed:
Another NYU Langone study, which focused on patients under the age of 60, found that those with obesity were twice as likely to be hospitalized and were at even higher risk of requiring critical care.
In fact, by July 2020, enough data had accumulated that to allow for an review on the topic titled “The Potential Impacts of Obesity on COVID-19“. By this early date, the author was able to reference several papers and conclude:
Obesity has been found to be a strong independent risk factor for hospitalisation in COVID-19, and to cause or exacerbate a variety of comorbidities which have been proven to be associated with increased morbidity and mortality among COVID-19 patients.
In September 2020, Science published an article titled “Why COVID-19 is More Deadly in People with Obesity—Even if They’re Young“. It quoted a doctor who said:
These were otherwise healthy, hard-working people. Their major risk factor for getting this sick was obesity.
Maybe seven medical journals rejected Dr. Makary’s paper for reasons that had nothing to do with censoring the link between obesity and COVID.
Let’s return to the title of Dr. Makary’s article, Does Anyone Still Care About Data? Many people do, and Sensible Medicine doctors taunt them by robotically levelling the same juvenile accusation of “groupthink”. This, of course, is just medical groupthink from the medical establishment.
And if the doctors behind Sensible Medicine want to prove me wrong, they have my blessing to publish this essay on their site.
Medical groupthink from the medical establishment.