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A good doctor and researcher makes a factual statement, at his peril

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A good doctor and researcher makes a factual statement, at his peril

Twitter responds with vitriol - How silencing works

Vinay Prasad
Sep 11, 2022
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A good doctor and researcher makes a factual statement, at his peril

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Anil Makam is a consummate, caring clinician and a saavy, brilliant researcher. He's a colleague at the University California, San Francisco, and we both work at the same hospital: SFGH. Recently, he made a factual statement about his lived experience.

Twitter avatar for @AnilMakam
Anil Makam @AnilMakam
I'm back on service. Cared for ~20 unique people past 4 days 0 patients hospitalized FOR covid 0 patients hospitalized WITH covid 0 patients with long covid as comorbidity good news! severe covid is gone long covid is real but not nearly at prevalence suggested
8:42 PM ∙ Sep 6, 2022
337Likes32Retweets

His point is undeniable. The new variant is less lethal. When you combine this with high rates of natural immunity, and vaccination, the net result is simple: the IFR for Covid19 is now far less than flu. That's what many Americans intuitively get, which is why they have returned to normal. It also means policy needs to readjust. The emergency is over.

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The response he got was horrific. Doctors tagged him employer-- a spineless attempt to cause professional repercussions. Users mocked his profile, photo, and job description. They insulted him in dozens of tweets. They mocked his experience in EBM and research skills. They said they hoped he didn't teach students this sort of thinking. One person took Anil's photo and vandalized it, making him look like a clown. Dozens of doctors and professors participated, liking nasty tweets and baiting the mob. I was horrified and sickened to watch it.

I am not the only one who felt the response was out of line. Once again the courageous Walid Gellad chimed in:

Twitter avatar for @walidgellad
Walid Gellad, MD MPH @walidgellad
@VPrasadMDMPH The comments from other MDs to @AnilMakam are hypocritical, unfair, and unhelpful. Hopefully the young MDs and those in training don’t think this is how we treat people who espouse views we might disagree with. Fine to directly disagree with someone. Not fine to do this stuff.
4:53 PM ∙ Sep 11, 2022

Of course, Anil's comment is correct and speaks to a deeper truth. We need to readjust our policy to account for the changing circumstances. The emergency over. EUA authority needs to be revoked. Perpetually masking doesn't make sense. And we all need to accept that COVID is here to stay, and normal is returning.

Why did Anil get such hate for sharing his lived experience?

I think we know why. Those who replied may be personally afraid or have built an audience of the afraid. They're not ready to resume normal life. They are afraid of going out unmasked, and they are frustrated by how many Americans have returned to normal. Some may be suffering from untreated anxiety disorder or other mental health ailments. They are, in part, harsh on Anil because they fear for their life. Or they cater to an audience who does.

But they also are harsh on Anil to set an example. They don't want other people to speak like him. The best way to discourage people from talking sensibly about COVID is to humiliate, bully and attack those who do. Leana Wen has been a victim. So has John Ioannidis. Now the mob comes for Anil.

This is the reason why so many researchers are fed up with Twitter. This didn't happen 5 years ago. Now, It happens every 5 minutes. I think it's time to speak up when you see it.

I disagree with the mob and their tactics. Anil is a good doctor, smart man, and great researcher. He made a good point, which people should heed. Outside of Twitter it is not at all controversial. Leana Wen was called fat phobic for saying you should not eat Krispy Kreme donuts daily. Guess what? You shouldn't. Duh.

Young academics who want to build a better culture in online discourse should not participate in pile ons. Moreover they should block people who fuel attacks like this. Bots that like or RT should also be blocked. Blocks can work like cutting a firebreak, now and in the future, preventing widespread fires. Mass blocking tools-- like NukeTweet can be used for the most hateful comments. Blocking all those who fuel this vitriol.

Ultimately, a new social media platform to discuss medicine and science might be needed. One that rewards centrism and not outrage. One that prioritizes generous readings as opposed to uncharitable ones. I hope one can be made, but founder effects are strong. Only time will tell. In the meantime, if this offends you, send your support to Anil Makam. He is active on Twitter and worth a follow.

Vinay Prasad's Observations and Thoughts is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

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A good doctor and researcher makes a factual statement, at his peril

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37 Comments
Ari Reddy
Sep 11, 2022

The situation is infuriating, some previously serious academics have built social media followings catering to the fearful and anxious and are now loathe to give that up, even if they are psychologically damaging their followers by reinforcing their false beliefs that fuel their anxiety. Personally I think it violates “do no harm.”

As you said, they should know better, behave better, and if they truly believe the unrealistically high risk they are promoting they are also suffering from an anxiety disorder as well as unintentionally reinforcing other people’s problem too.

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Daniel Bruetman MD, MMM
Sep 11, 2022

I’m a physician who is currently enrolled in a Master of Liberal Arts program. Our class on totalitarianism exposed me to the idea that societal silencing and canceling is as dangerous and toxic, maybe worse than state sponsored censorship. State authority can physically eliminate a person, society can crush a person’s soul.

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