The fact that the goal post for approval of Covid vaccine for the very youngest children was lowered to “non inferior antibodies”. I will remember that phrase until I die. ANYONE who maintained the one size fits all and safe and effective narrative despite compelling contrary evidence needs to leave and seek employment outside of health and medicine. Also the MMWR needs outside review prior to publishing. I nearly choked on some of their retrospective masking studies. The other paper I will never forget was the New York comparison of hospitalization rates of vaccinated versus unvaccinated children. The confidence interval crossed unity, (no conclusion can be drawn). Yet the next day every major media television guest MD commentator touted now there should be no hesitancy for parents to give their children Covid vaccines. Did these guys get their degrees from K-Mart? The FDA, ACIP, and CDC along with local health departments have a boat load of ‘mea culpa’ to own up to.
These changes, which simply fall under the category of behaving with integrity, would be a great start. I would add a new policy change at the CDC: important changes on the website would be ANNOUNCED, not just quietly brushed under the carpet. For example, when the COVID vaccine was shown to NOT halt transmission, the CDC quietly changed the wording on their website to acknowledge, but this was not apparent unless someone had screen-shotted the "before and after" texts. And a person would have to be pretty paranoid to do that.....This type of revisionism was not a problem in the days of print journals.
That's a good idea for all government agencies. They should have to save copies of their web pages and archive them whenever they change something. That might take a lot of server space, but maybe the NSA could spare some.
Thank you Dr. Prasad for all the great things you do. I am amazed at your intelligence, insight and honesty. May you be blessed to continue these good works. TB
Yes, yes, YES!! Someone with a presence on X, please, please post this to all the relevant people so this can become widespread!
I especially love the advice to stop masking (a dear friend of mind still masks herself and her children from time to time, and I want them to be free of that), and removing the covid vaccine from the childhood immunization schedule. The latter is SO removed from reality and common sense that it is borderline criminal that they are still creating and pushing these vaccines!!
There are SO many people who are completely unwilling to say "We were wrong and we are sorry." Public Health, yes, but also politicians, universities, businesses that went along with all the madness, churches that closed until the gov't money ran out... I don't see it ever happening but we can hope! We can also hope Dr. Prasad ends up with a prominent role in Public Health!
Some excellent points. You are forgetting another major error of the CDC and that is their arrogance which delayed accurate testing for COVID.
But why the hatred on masking? Yes I know that Cochrane concluded that community masking didn’t work but there are no studies that show a well fit N95 doesn’t offer protection. What do you tell your immunocompromised patients? And what if we have a flu epidemic where masks probably would help to prevent spread? Maybe you could spend some time with your immunocompromised patients making sure they have a good fit on their N95 instead of getting them a cup of coffee.
I feel like i’m the old wise physician having to take the young whippersnapping upstart to the woodshed.
Recall that Cochran found no evidence in favor of n95s and a Cleveland clinic rct on healthcare workers found no difference between surgical and n95 masks. No surprise since aerosols are small enough to penetrate an n95, never mind that it is impossible to properly wear a well fitted n95 for more than 20 min, after which time the mask will be saturated and ineffective in any case.
Please provide support for time limit of an N95. Covid virions may hitch a ride on small droplets allowing N95s to be effective. Cochrane conclusions were not high confidence. This study shows n95s are effective for preventing those with covid from emitting virus. It would seem to follow that a noncovid wearer might benefit from the n95 barrier. ohttps://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(24)00192-0/fulltext
There is enough of a question about the efficacy of N95s that I feel that a physician (Vinay Prasad) shouldn’t shame or belittle an immunocompromised patient who opts to wear one.
The well-fit N95 may work, but there are still too many to people walking around with loose-fitting cloth masks (and putting them on their children), thinking they are keeping themselves from getting sick, so I understand Vinay’s heart behind that point. A distinction would be helpful though, I agree!
Hear, hear. I agree with VP a lot, but sometimes he's a real arrogant little .... (fill in the blank). He should get over himself. And maybe balance things with some evidence-based criticism of King Trump and his sycophantic courtiers.
"Which with suggest"? What is that supposed to mean?
For example, "Global warming is a hoax"? "Burn more fossil fuels and pollute the air more"? "Shut down the EPA 65% and put a fossil fuel executive in charge"?
Therefore, according to Trump World, MAHA (ha, ha): Global warming and particulate air pollution are not the greatest global public health disaster ever--already and more to come. I wish your children and grandchildren good luck with that. I could say more.
You should read the iea's new global energy report. It shows that the rate of decarbonization of GDP has been constant since 1965. So despite the fact that I'm sure you love to show everyone how much you care about this topic, no Grand pronouncements appear to affect anything.
So you disbelieve the three largest mask studies that clearly showed face diapers don't do diddly squat, but you prefer the shitty observational and low quality small studies that people claimed to justify their fear bias for "mask is better than nothing", the anti-science position. Great! You sound like Bret Weinstein arguing against RCTs!
A FRESH TIGHT FITTED N95 partially works for a few minutes, in a hospital room. That's it, you'll never get past that mark, because we breath, we breath on each other, and that's normal, and if you're averse to breathing on each other you don't belong in society, or live in a hazard suit, but stop imposing your hysteria on the rest of society.
Cochrane shows community masking isn’t effective. I don’t see any studies where motivated patients wore well fitted N95s. My point is you shouldn’t shame people if they want to wear an N95. Another point: There really isn’t much science in any of these studies.
Please support your contention that masks only work for minutes.
I cannot agree more with ALL. Please Susan Monarez, read this and start now with #1! Sane, intelligent people admit making errors and learn from them. Speak the truth, make sense. 🙏🏼
I enjoyed reading your post today. You always try to put some humor or hyperbole in them. I hope the new FDA commissioner, Marty Makary, MD, reads your post today and gets to work!
Agree, it’s time for prospective studies. Post pandemic there is no reason to do shit observational research, at least on the COVID vaccine. We are seeing the public health collateral damage with all the measles outbreaks.
Stop the measles hysteria. It's been a nothing burger since before the vax came along. In fact, childhood benign illnesses were GOOD at population level.
The current measles outbreak is simply part of the 5 year recurrence pattern. Why 5 years nobody knows but that’s what it happens to be. Mmr vaccine penetration is as high as it’s ever going to get.
I’d say firewall is not enough. Data collection and analysis efforts should be housed under NIH. This relationship should be similar to the relationship between FAA and NTSB.
I’d be ecstatic if all they did was point number 1
The fact that the goal post for approval of Covid vaccine for the very youngest children was lowered to “non inferior antibodies”. I will remember that phrase until I die. ANYONE who maintained the one size fits all and safe and effective narrative despite compelling contrary evidence needs to leave and seek employment outside of health and medicine. Also the MMWR needs outside review prior to publishing. I nearly choked on some of their retrospective masking studies. The other paper I will never forget was the New York comparison of hospitalization rates of vaccinated versus unvaccinated children. The confidence interval crossed unity, (no conclusion can be drawn). Yet the next day every major media television guest MD commentator touted now there should be no hesitancy for parents to give their children Covid vaccines. Did these guys get their degrees from K-Mart? The FDA, ACIP, and CDC along with local health departments have a boat load of ‘mea culpa’ to own up to.
These changes, which simply fall under the category of behaving with integrity, would be a great start. I would add a new policy change at the CDC: important changes on the website would be ANNOUNCED, not just quietly brushed under the carpet. For example, when the COVID vaccine was shown to NOT halt transmission, the CDC quietly changed the wording on their website to acknowledge, but this was not apparent unless someone had screen-shotted the "before and after" texts. And a person would have to be pretty paranoid to do that.....This type of revisionism was not a problem in the days of print journals.
That's a good idea for all government agencies. They should have to save copies of their web pages and archive them whenever they change something. That might take a lot of server space, but maybe the NSA could spare some.
Server space is near free and it would be a far better use of the money extorted from us than 99% of the current expenditure categories.
Thank you Dr. Prasad for all the great things you do. I am amazed at your intelligence, insight and honesty. May you be blessed to continue these good works. TB
Yes, yes, YES!! Someone with a presence on X, please, please post this to all the relevant people so this can become widespread!
I especially love the advice to stop masking (a dear friend of mind still masks herself and her children from time to time, and I want them to be free of that), and removing the covid vaccine from the childhood immunization schedule. The latter is SO removed from reality and common sense that it is borderline criminal that they are still creating and pushing these vaccines!!
Unless they name you CDC director, I'm not holding my breath for any of these!
There are SO many people who are completely unwilling to say "We were wrong and we are sorry." Public Health, yes, but also politicians, universities, businesses that went along with all the madness, churches that closed until the gov't money ran out... I don't see it ever happening but we can hope! We can also hope Dr. Prasad ends up with a prominent role in Public Health!
Some excellent points. You are forgetting another major error of the CDC and that is their arrogance which delayed accurate testing for COVID.
But why the hatred on masking? Yes I know that Cochrane concluded that community masking didn’t work but there are no studies that show a well fit N95 doesn’t offer protection. What do you tell your immunocompromised patients? And what if we have a flu epidemic where masks probably would help to prevent spread? Maybe you could spend some time with your immunocompromised patients making sure they have a good fit on their N95 instead of getting them a cup of coffee.
I feel like i’m the old wise physician having to take the young whippersnapping upstart to the woodshed.
Recall that Cochran found no evidence in favor of n95s and a Cleveland clinic rct on healthcare workers found no difference between surgical and n95 masks. No surprise since aerosols are small enough to penetrate an n95, never mind that it is impossible to properly wear a well fitted n95 for more than 20 min, after which time the mask will be saturated and ineffective in any case.
Please provide support for time limit of an N95. Covid virions may hitch a ride on small droplets allowing N95s to be effective. Cochrane conclusions were not high confidence. This study shows n95s are effective for preventing those with covid from emitting virus. It would seem to follow that a noncovid wearer might benefit from the n95 barrier. ohttps://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(24)00192-0/fulltext
There is enough of a question about the efficacy of N95s that I feel that a physician (Vinay Prasad) shouldn’t shame or belittle an immunocompromised patient who opts to wear one.
The well-fit N95 may work, but there are still too many to people walking around with loose-fitting cloth masks (and putting them on their children), thinking they are keeping themselves from getting sick, so I understand Vinay’s heart behind that point. A distinction would be helpful though, I agree!
Hear, hear. I agree with VP a lot, but sometimes he's a real arrogant little .... (fill in the blank). He should get over himself. And maybe balance things with some evidence-based criticism of King Trump and his sycophantic courtiers.
On issues of medicine and health, which with suggest?
Was supposed to say which would you suggest.
I'm sure V would say particulates are a legitimate concern but pretend solutions don't do anything.
"Which with suggest"? What is that supposed to mean?
For example, "Global warming is a hoax"? "Burn more fossil fuels and pollute the air more"? "Shut down the EPA 65% and put a fossil fuel executive in charge"?
Therefore, according to Trump World, MAHA (ha, ha): Global warming and particulate air pollution are not the greatest global public health disaster ever--already and more to come. I wish your children and grandchildren good luck with that. I could say more.
What do you say Vinay?
You should read the iea's new global energy report. It shows that the rate of decarbonization of GDP has been constant since 1965. So despite the fact that I'm sure you love to show everyone how much you care about this topic, no Grand pronouncements appear to affect anything.
You don't understand the burden of proof. One must demonstrate that the measure works, not that it doesn't!
The mask studies were crap and you know it.
So you disbelieve the three largest mask studies that clearly showed face diapers don't do diddly squat, but you prefer the shitty observational and low quality small studies that people claimed to justify their fear bias for "mask is better than nothing", the anti-science position. Great! You sound like Bret Weinstein arguing against RCTs!
A FRESH TIGHT FITTED N95 partially works for a few minutes, in a hospital room. That's it, you'll never get past that mark, because we breath, we breath on each other, and that's normal, and if you're averse to breathing on each other you don't belong in society, or live in a hazard suit, but stop imposing your hysteria on the rest of society.
Cochrane shows community masking isn’t effective. I don’t see any studies where motivated patients wore well fitted N95s. My point is you shouldn’t shame people if they want to wear an N95. Another point: There really isn’t much science in any of these studies.
Please support your contention that masks only work for minutes.
Uh I believe you’re the hysterical one.
I cannot agree more with ALL. Please Susan Monarez, read this and start now with #1! Sane, intelligent people admit making errors and learn from them. Speak the truth, make sense. 🙏🏼
Dr. Prasad, would you consider accepting a position with CDC if offered? Dr. Jay will need some help setting things right.
Let’s not forget a major benefit of still masking. It shows you are 100% against anything Trump says or does.
Well, to be fair, some things he says or does are Ok, until he flip flops. And even broken clocks are right twice a day.
I enjoyed reading your post today. You always try to put some humor or hyperbole in them. I hope the new FDA commissioner, Marty Makary, MD, reads your post today and gets to work!
I do not believe they will ever apologize. I would vote for AOC for president, however, if they do. And I’d vote Kim Jong Il before I’d vote for her.
Agree, it’s time for prospective studies. Post pandemic there is no reason to do shit observational research, at least on the COVID vaccine. We are seeing the public health collateral damage with all the measles outbreaks.
Stop the measles hysteria. It's been a nothing burger since before the vax came along. In fact, childhood benign illnesses were GOOD at population level.
The current measles outbreak is simply part of the 5 year recurrence pattern. Why 5 years nobody knows but that’s what it happens to be. Mmr vaccine penetration is as high as it’s ever going to get.
Fantastic suggestions! Thank you!
I’d say firewall is not enough. Data collection and analysis efforts should be housed under NIH. This relationship should be similar to the relationship between FAA and NTSB.