It's hard to argue with people who are gaslighting you and have been doing so for 3 years. Their goal is not the same as yours: it's to justify their position because it works for them, not to engage in a relentless pursuit of the truth. This is why arguing with gaslights rarely ends well. Most of the time they don't even realize they are gaslighting: they just find themselves defending their positions like the Black Knight in Monty Python and the Holy Grail, when it has become beyond absurd to do so.
The problem is that in academia and public health, the incentives have become perverse. They aren't trying to conduct science, to learn and understand how things work in a reproducible way.
The goal is to publish and say lots of things. No one appears concerned with making accurate claims. No one is even checking if you are correct. There is zero accountability when you are wrong. No one appears concerned with trying to be accurate, admitting when they are wrong, and discovering how to improve their accuracy.
It's crazy to me.
In the private sector, typically when you are wrong, you pay a price. You lose the promotion if not the job. If you make a model that shows it takes 10 factories to meet the demand for 1 million widgets, and when you model is executed it only makes 500,000 widgets, you lose your job. If you are a sales executive and promise a 50% increase in sales and only deliver 20%, you are fired.
In public health, Donna Ginther can say that Kansas counties that masked had a 100% decrease in Covid cases in an embarrassing study where simple replication of the claims done at time of publication showed a .3% absolute difference - yet she maintains her position as Distinguished Professor of Economics and director of the Institute for Policy & Social Research at the University of Kansas.
Your Local Epidemiologist Katelyn Jetelina can claim: "believe it or not, we continue to see a beautiful correlation between country-level vaccination rates and case rates/deaths" [1] citing an article from Der Spiegel [2] which if she had bothered to double check was already out of date by the time she reported on it, as cases in her highly vaccinated countries she praised like Denmark and Portugal exploded. Despite being it brought to her attention [3], she doesn't ever go back and examine how she got this wrong.
She remarks in a conversation with Dr. "19-tweets-to-explain-why-he's-ready-to-have-dinner-outdoors-without-a-mask" Watcher in December on how she knows masks work [4] "I keep thinking of 'why does my surgeon wear a mask when I am in surgery' you know, it must do something, it has to work". She reads all of her comments but ignores polite corrections showing her mistakes [5].
She continues to be acknowledged as an expert.
Even if you weren't fired in private sector for being so consistently wrong, you would at least be "window seated".
Epi Ellie gets to write a paper on the importance Boston School Masks not disclosing the authors successfully ran a Change.org petition to bring masks back to Boston Schools and wrote editorials begging to bring back masks [6], failed to realize several schools they counted as "Mask" got exceptions to drop masks [7], and when asked to explain all the confounders (like the fact the group counted as No Mask already had a higher baseline of cases when they were mandated to mask) argued "trust me, I have a PhD" [8]. The paper is not withdrawn, her job is intact. How?
What is most frustrating about all of this, is that these people are very intelligent. They believe they have the best intentions, they believe what they are doing is right. Katelyn Jetelina appears to be a very compassionate and hard working person.
As individuals I don't blame them. All of these people are incentivized to produce essays, studies, and commentaries without respect to being right or wrong. Thats a systemic problem of how "we", collectively, have organized the pursuit of science. It's absolutely broken.
There needs to be soul searching in "The Science" to understand how it is possible to generate 75 studies that find cloth masks make a huge difference in virus transmission. We know with near certainty this cannot be true, yet pooled together, ~1200 PhDs managed to find, over and over, that cloth masks worked. That is an indictment of how bad we are at sciencing.
Agreed! I am frustrated by the argument that this was a novel virus. The target was always moving. Sorry but pure baloney. Every patient is novel. That was just an excuse to manipulate. The doctors " managing" the pandemic failed. They are paired very healthy salaries and failed.
The literal textbook example of pioneering public health is English Dr. John Snow’s work to find the source of cholera in London. By using a geographical grid to chart deaths from the outbreak and investigating each case to determine access to a specific pump’s water, Snow developed what he considered positive proof that specific pump was the source of the epidemic. He convinced officials to take the pump handle off, and cholera cases immediately dropped. He did not push the idea of cutting off all city water, “out of an abundance of caution,” with no evidence, nor come up with other draconian recommendations. He found the source, quickly, and acted on the source of the disease. However, officials still didn’t believe his assertions about the water being contaminated from nearby cesspools. The Board of Health issued a report that said, “we see no reason to adopt this belief” and shrugged off Snow’s evidence as mere “suggestions.” Sound familiar? Students of public health laugh at this response now. If it was ridiculous then, it is just as ridiculous now.
I continue to appreciate VPs clear thoughts on the failures of public health in these recent years, but I continue to wonder about the elephant which continues to dance in a pink tutu in the background, namely this: centralized authority as it has been observed in so much of recorded human history always finds itself in service, ultimately, only to... itself. I believe we can say a "better bureaucracy" is an oxymoron, whether we're speaking of public health or the Biz of Medicine. It's simply a fact that the priorities of larger and larger organizations drift toward different ROI discussions and the self-preservation efforts on the part of the functionaries within. Dismantling the big letter organizations is essential, and while the dismantling happens, reinvigorating a citizen's rights to decline their edicts should be seen as a first priority. But to contemplate any New and Improved version of any such entity is the definition of insanity and merely invites the next debacle.
When public health acts like medicine and removes choice with mandates, it should have to operate like medicine. Even in medicine we always have choice. And in the pandemic we could really say that public health is what removed informed consent.
It is profoundly odd that so few good trials emerged from COVID in the US. You would have thought that there was equipoise about many many things and plenty of money at various points for "shovel ready" projects that could have addressed them. I think part of the problem is that most doctors and nurses are not scientists anymore than most people - they learned a lot about science in training but they aren't practitioners of doubt and alternative theorizing. So when they experience something like positive results for proning or convalescent plasma they are done and the question is no longer at equipoise.
Do you know why I *KNOW* n95/cloth masks don't work? In the army, we train for NBC (nuclear, biological, chemical) attacks. The standard is to hermetically seal your gas masks within 9 seconds. That means taking it out of the carrier, putting it on, sealing the mask and testing the seal. Then you have 6 seconds to put the hood over your shoulder. To test whether it's hermetically sealed or not, they often put CS gas into white smoke. CS is military grade tear gas that is FAR FAR worse than anything the police use. It will WRECK your day. Just google "army cs gas chamber" So we train to use hermetically sealed gas masks for bacteria that's an order or two magnitude greater in size than a virus. So tell me again how gappy masks N95 or cloth can truly protect you from this virus?
Fun fact: When training with the gas mask, you tend to sweat A LOT. Especially in Ft. Benning, GA. So what happens to all that sweat? It pools up inside your mask because it's, well, hermetically sealed. So at some point, you have two choices. Break the seal and let the sweat drain out, or drink your own sweat.
Question for you: if technically we are still in the phase 3 trial period of the covid vax then where is the control group? I know that people claim that the FDA "approved" it so we are no longer in a study but thats just a formality. My understanding is that phase 3 trials of new vaxes take years. I looked it up and the current new Shingrix booster took 4 years to get through phase 3 trials. SO am I wrong. Shouldnt pfizer and the CDC be still collecting data on unvaxed , never infected and unvaxxed and naturally recovered people to see how they fared COMPARED to the vaxxed? Thank you
I lost my faith in public health during the opiate epidemic both personally and professionally. Evidence-based and SAMHSA approved treatments fell by the wayside in favor of opioid medications. Every time I hear an opioid touted as “non-addicting” we know it’s going to be misused. I watched it happen with the OXY drugs. I watched it happen with tramadol, and I watch it happening now with buprenorphine. Yet they ignore that evidence because it doesn’t make them any money. 12 step recovery is well supported by both evidence, and time, yet it’s now harm reduction. Keeps a low bar low.
I have no idea what “public health” means, other than what is still misunderstood by most after-the-fact. Doctors should be as free as their patients to make decisions and choices; free to think and evolve ideas and therapies without the looming fear from an authoritarian power looking over our shoulders ready to exact punishment for daring to test established norms consistently getting it wrong. I’m always thinking: All these damn wars over the centuries and still we are so unfree, still. Freedom, Choice and Self-Determination shouldn’t be so difficult to establish by developing, democratic societies, yet I don’t recognize real freedom anywhere in the world to date. So sad.
Your assessment of public health certainly provides a rationale for the perpetual threat inflation surrounding Covid. Much like the so-called "missile gap" thar repeated American presidents used to justify massive funding increases for the Pentagon, so too has Covid been viewed as the new golden goose used to generate billions in long neglected research from a traditionally underfunded area, i.e. public health) Proper testing and requests for hard evidence might not allow this state of perpetual panic to be sustained (almost by definition greater knowledge usually engenders more measured reactions/policies). Hence, the tendency to apply a different standard when evidence based science undercuts the prevailing wisdom.
Once Covid is milked as much as possible, get ready for the next generated public panic. It was tried already with Monkeypox. That didn't work, bit I'm sure some variant of bird flu, or even another lab leak could well do the trick. It's the easiest way to ensure ongoing sustenance from the government teat.
Too much of public health, and medicine, is founded on tradition. Traditions that need confirmation by good science before recommending at large. Mandates stem from politics mixed with PH. The worst application of ideological “belief” possible. VP is right, as usual, population level recommendations need good evidence of benefit anymore.
‘Had it not been for this particular virus leaking out of the la— I mean wet market— we would not have thought of public health for another 20 years.’ Lol Dr Prasad, you are poking the bear!
It's hard to argue with people who are gaslighting you and have been doing so for 3 years. Their goal is not the same as yours: it's to justify their position because it works for them, not to engage in a relentless pursuit of the truth. This is why arguing with gaslights rarely ends well. Most of the time they don't even realize they are gaslighting: they just find themselves defending their positions like the Black Knight in Monty Python and the Holy Grail, when it has become beyond absurd to do so.
The problem is that in academia and public health, the incentives have become perverse. They aren't trying to conduct science, to learn and understand how things work in a reproducible way.
The goal is to publish and say lots of things. No one appears concerned with making accurate claims. No one is even checking if you are correct. There is zero accountability when you are wrong. No one appears concerned with trying to be accurate, admitting when they are wrong, and discovering how to improve their accuracy.
It's crazy to me.
In the private sector, typically when you are wrong, you pay a price. You lose the promotion if not the job. If you make a model that shows it takes 10 factories to meet the demand for 1 million widgets, and when you model is executed it only makes 500,000 widgets, you lose your job. If you are a sales executive and promise a 50% increase in sales and only deliver 20%, you are fired.
In public health, Donna Ginther can say that Kansas counties that masked had a 100% decrease in Covid cases in an embarrassing study where simple replication of the claims done at time of publication showed a .3% absolute difference - yet she maintains her position as Distinguished Professor of Economics and director of the Institute for Policy & Social Research at the University of Kansas.
Your Local Epidemiologist Katelyn Jetelina can claim: "believe it or not, we continue to see a beautiful correlation between country-level vaccination rates and case rates/deaths" [1] citing an article from Der Spiegel [2] which if she had bothered to double check was already out of date by the time she reported on it, as cases in her highly vaccinated countries she praised like Denmark and Portugal exploded. Despite being it brought to her attention [3], she doesn't ever go back and examine how she got this wrong.
She remarks in a conversation with Dr. "19-tweets-to-explain-why-he's-ready-to-have-dinner-outdoors-without-a-mask" Watcher in December on how she knows masks work [4] "I keep thinking of 'why does my surgeon wear a mask when I am in surgery' you know, it must do something, it has to work". She reads all of her comments but ignores polite corrections showing her mistakes [5].
She continues to be acknowledged as an expert.
Even if you weren't fired in private sector for being so consistently wrong, you would at least be "window seated".
Epi Ellie gets to write a paper on the importance Boston School Masks not disclosing the authors successfully ran a Change.org petition to bring masks back to Boston Schools and wrote editorials begging to bring back masks [6], failed to realize several schools they counted as "Mask" got exceptions to drop masks [7], and when asked to explain all the confounders (like the fact the group counted as No Mask already had a higher baseline of cases when they were mandated to mask) argued "trust me, I have a PhD" [8]. The paper is not withdrawn, her job is intact. How?
What is most frustrating about all of this, is that these people are very intelligent. They believe they have the best intentions, they believe what they are doing is right. Katelyn Jetelina appears to be a very compassionate and hard working person.
As individuals I don't blame them. All of these people are incentivized to produce essays, studies, and commentaries without respect to being right or wrong. Thats a systemic problem of how "we", collectively, have organized the pursuit of science. It's absolutely broken.
There needs to be soul searching in "The Science" to understand how it is possible to generate 75 studies that find cloth masks make a huge difference in virus transmission. We know with near certainty this cannot be true, yet pooled together, ~1200 PhDs managed to find, over and over, that cloth masks worked. That is an indictment of how bad we are at sciencing.
_____________
[1] https://yourlocalepidemiologist.substack.com/p/state-of-affairs-europe-should-we
[2] https://archive.ph/M138c
[3] https://yourlocalepidemiologist.substack.com/p/omicron-update-nov-29/comments?s=r
[4] https://www.youtube.com/watch?v=vu4rK8dAgnU&t=2005s
[5] https://archive.ph/XLBwb#selection-563.39-563.159
[6] https://twitter.com/EpiEllie/status/1429102872470433795 , https://www.bostonglobe.com/2022/02/11/opinion/its-too-soon-lift-school-mask-mandate/
[7] https://www.cbsnews.com/boston/news/massachusetts-schools-mask-mandate-lifted-list-dese/
[8] https://twitter.com/EpiEllie/status/1557497452781096960?s=20&t=20X-EaQtKJAw3a0mwTzSTg
Agreed! I am frustrated by the argument that this was a novel virus. The target was always moving. Sorry but pure baloney. Every patient is novel. That was just an excuse to manipulate. The doctors " managing" the pandemic failed. They are paired very healthy salaries and failed.
The literal textbook example of pioneering public health is English Dr. John Snow’s work to find the source of cholera in London. By using a geographical grid to chart deaths from the outbreak and investigating each case to determine access to a specific pump’s water, Snow developed what he considered positive proof that specific pump was the source of the epidemic. He convinced officials to take the pump handle off, and cholera cases immediately dropped. He did not push the idea of cutting off all city water, “out of an abundance of caution,” with no evidence, nor come up with other draconian recommendations. He found the source, quickly, and acted on the source of the disease. However, officials still didn’t believe his assertions about the water being contaminated from nearby cesspools. The Board of Health issued a report that said, “we see no reason to adopt this belief” and shrugged off Snow’s evidence as mere “suggestions.” Sound familiar? Students of public health laugh at this response now. If it was ridiculous then, it is just as ridiculous now.
I continue to appreciate VPs clear thoughts on the failures of public health in these recent years, but I continue to wonder about the elephant which continues to dance in a pink tutu in the background, namely this: centralized authority as it has been observed in so much of recorded human history always finds itself in service, ultimately, only to... itself. I believe we can say a "better bureaucracy" is an oxymoron, whether we're speaking of public health or the Biz of Medicine. It's simply a fact that the priorities of larger and larger organizations drift toward different ROI discussions and the self-preservation efforts on the part of the functionaries within. Dismantling the big letter organizations is essential, and while the dismantling happens, reinvigorating a citizen's rights to decline their edicts should be seen as a first priority. But to contemplate any New and Improved version of any such entity is the definition of insanity and merely invites the next debacle.
When public health acts like medicine and removes choice with mandates, it should have to operate like medicine. Even in medicine we always have choice. And in the pandemic we could really say that public health is what removed informed consent.
It is profoundly odd that so few good trials emerged from COVID in the US. You would have thought that there was equipoise about many many things and plenty of money at various points for "shovel ready" projects that could have addressed them. I think part of the problem is that most doctors and nurses are not scientists anymore than most people - they learned a lot about science in training but they aren't practitioners of doubt and alternative theorizing. So when they experience something like positive results for proning or convalescent plasma they are done and the question is no longer at equipoise.
Do you know why I *KNOW* n95/cloth masks don't work? In the army, we train for NBC (nuclear, biological, chemical) attacks. The standard is to hermetically seal your gas masks within 9 seconds. That means taking it out of the carrier, putting it on, sealing the mask and testing the seal. Then you have 6 seconds to put the hood over your shoulder. To test whether it's hermetically sealed or not, they often put CS gas into white smoke. CS is military grade tear gas that is FAR FAR worse than anything the police use. It will WRECK your day. Just google "army cs gas chamber" So we train to use hermetically sealed gas masks for bacteria that's an order or two magnitude greater in size than a virus. So tell me again how gappy masks N95 or cloth can truly protect you from this virus?
Fun fact: When training with the gas mask, you tend to sweat A LOT. Especially in Ft. Benning, GA. So what happens to all that sweat? It pools up inside your mask because it's, well, hermetically sealed. So at some point, you have two choices. Break the seal and let the sweat drain out, or drink your own sweat.
Question for you: if technically we are still in the phase 3 trial period of the covid vax then where is the control group? I know that people claim that the FDA "approved" it so we are no longer in a study but thats just a formality. My understanding is that phase 3 trials of new vaxes take years. I looked it up and the current new Shingrix booster took 4 years to get through phase 3 trials. SO am I wrong. Shouldnt pfizer and the CDC be still collecting data on unvaxed , never infected and unvaxxed and naturally recovered people to see how they fared COMPARED to the vaxxed? Thank you
I lost my faith in public health during the opiate epidemic both personally and professionally. Evidence-based and SAMHSA approved treatments fell by the wayside in favor of opioid medications. Every time I hear an opioid touted as “non-addicting” we know it’s going to be misused. I watched it happen with the OXY drugs. I watched it happen with tramadol, and I watch it happening now with buprenorphine. Yet they ignore that evidence because it doesn’t make them any money. 12 step recovery is well supported by both evidence, and time, yet it’s now harm reduction. Keeps a low bar low.
I have no idea what “public health” means, other than what is still misunderstood by most after-the-fact. Doctors should be as free as their patients to make decisions and choices; free to think and evolve ideas and therapies without the looming fear from an authoritarian power looking over our shoulders ready to exact punishment for daring to test established norms consistently getting it wrong. I’m always thinking: All these damn wars over the centuries and still we are so unfree, still. Freedom, Choice and Self-Determination shouldn’t be so difficult to establish by developing, democratic societies, yet I don’t recognize real freedom anywhere in the world to date. So sad.
You think public health seeks the serve public? Lololol.
Your assessment of public health certainly provides a rationale for the perpetual threat inflation surrounding Covid. Much like the so-called "missile gap" thar repeated American presidents used to justify massive funding increases for the Pentagon, so too has Covid been viewed as the new golden goose used to generate billions in long neglected research from a traditionally underfunded area, i.e. public health) Proper testing and requests for hard evidence might not allow this state of perpetual panic to be sustained (almost by definition greater knowledge usually engenders more measured reactions/policies). Hence, the tendency to apply a different standard when evidence based science undercuts the prevailing wisdom.
Once Covid is milked as much as possible, get ready for the next generated public panic. It was tried already with Monkeypox. That didn't work, bit I'm sure some variant of bird flu, or even another lab leak could well do the trick. It's the easiest way to ensure ongoing sustenance from the government teat.
Too much of public health, and medicine, is founded on tradition. Traditions that need confirmation by good science before recommending at large. Mandates stem from politics mixed with PH. The worst application of ideological “belief” possible. VP is right, as usual, population level recommendations need good evidence of benefit anymore.
WTF
I love how folks make up their own scientific method
‘Had it not been for this particular virus leaking out of the la— I mean wet market— we would not have thought of public health for another 20 years.’ Lol Dr Prasad, you are poking the bear!