A very important post today from Vinay. I say thanks so much for calling out this guy out in San Diego. Regrettable as it is, I think we are seeing repeatedly now a public exposure of folks who just don't know jack-shit about biostatistics, epidemiology, or clinical evidence analysis. Such persons can be very "dangerous" in a public health information transfer sense because while they may well be "famous in their own fields", they know just enough buzzwords, jingles, and BS to get their feet into their mouths on a regular basis. Keep tightening the screws on all purveyors of nonsense!
I have developed personal "rules of engagement" regarding whom to trust these days when watching TV news shows that interview this or that "expert on COVID". Here is a summary: The more oleaginous the person is, the higher I raise the bullshit deflector panels, and right away. If the person uses her/his hands constantly when talking, raise those panels another notch; if the person keeps saying stuff like "moving forward", "leaning into", "outward facing" , or "we are spinning up our teams right now", then raise panels five notches higher. Finally, if the person lapses *even once* into talking in the patois of the teenaged mall rats by saying the word "LIKE" over and over, turn off the TV and like leave the room because this crap will like finally poison your mind like permanently.
After four decades on Wall Street I earned a hard nosed skepticism steeped in data. Imagine my surprise when I turned my retired focus on Healthcare and found those folks were just as self-interested?!?! And the political class...defense contractors...Big Food...ad nauseum. Are there no longer any ethical fiduciaries? As an independent thinker, I feel as vulnerable as a newly incarcerated San Quentin prisoner with no gang affiliation. It seems no one has our back.
I can rectify the healthcare business when I drop my foolish thoughts about businessmen caring about patients when I focus on the second word of healthcare business.
Great book for an intro to non-Covid vaccine trials lack of good safety data (nearly all trials done without a saline placebo; most RCT's used a "safe" vaccine as the placebo, so the "safety" was comparable).
All I can say about paxlovid is that everybody I know who has been doubly boosted, then contracted covid and treated with Paxlovid has suffered rebound immediately upon finishing the 5 day course - and that includes the Bidens, Fauci and Wallensky herself. While Anecdotal it is 100% so far. And no surprise given that Paxlovid is virostatic and not virocidal.
No one has explained why physicians are not prescribing ten days of Paxlovid in light of the well-documented rebound phenomenon. That would require an "off label" prescription which is perfectly legal and common sense. I hope that a fellow reader can bring light to this idea. The FDA has no intrinsic legal power to prevent physicians from writing off label prescriptions. That was what so outrageous early in the pandemic when the FDA tried to intimidate physicians from writing prescriptions for hydroxychloroquine. That was outrageous and did not provoke much in the way of protest from practicing physicians.
I retired from a long career in pediatrics last summer. We pediatricians and specialists were forced to prescribe many of our "routine" meds off label as they were never fully studied or approved for pediatric patients. The right choice was to be familiar with the drug and its pros and cons and go ahead and prescribe.
I will give you an example. Tacrolimus is the most potent and commonly used immunosuppressant for solid organ transplant recipients around the world. Although it has never been approved for lung transplantation (presumably because additional studies would be too costly and lung transplant physicians are going to use it anyway), it is routinely used for kidney, liver and heart transplantation as well as lung transplantation. It has been approved for pediatric liver transplantation on the basis of a two published studies in which less than 200 subjects took the drug. Nevertheless, it is now used routinely in many infants and children who receive lung, heart, liver and kidney transplants. That is the state of the art and the law.
I know Eric; I have had to deal with him over many years. He has always been a fraud...not only in this area. But because he is at Scripps and has had his share of R1s (all incestuous as R1s are) people recruit him to write these ridiculous comments. He gets paid a fortune to go speak nonsense to health groups. It all speaks poorly of Scripps for sure.
Both Vinay and Topol write commentary for MedPage. How Vinay can stand to be on the same platform (and sometimes the same page) with Topol boggles my mind.
As an oncologist and principal investigator, our findings were never published on Twitter. The major flaw is posting on a platform that is not intended to generate scientific debate, only opinion, propaganda, fanaticism and conspiracy theories.
That last paragraph was my parting paragraph in my letter of resignation 5 years ago when attempting to leave the field of addiction - like an idiot my ego sent me back for two more years with hope that I could help the system I had worked for would wake up to patient care versus bottom line care...I knew better but had enough hope that things might be better. I was naive - and a colleague in ID said that my field wasn’t the only corrupted one. How naive I was...
The good news is that I’m in a position today to pay it forward and I still do the recovery work and help others...I just don’t charge and it ain’t pharma based recovery (pharma keeps a low bar very low)
Slight change of subject, but FWIW-----I remember seeing a tweet from Dr. Jha from the days before he was WH Covid czar, when he was still at Brown. He was commenting on something-or-other, and someone had been yelling about masks. He said that “masks help-----a little,” and went into some of the reasons that mask mandates are not the be-all and end-all that some folks think. I doubt that he would allow himself to make the same explanation today, as it’s a bit against the party line. I haven’t heard him comment on masks lately, and maybe he isn’t willing to speak about it, but surely his compatriots would be unhappy with him. Personal theory: Rochelle Walensky and pals pooh-pooh the Cochrane review because they are desperately trying to save face.
I worked in public education for quite a few years and remember at a conference one of the speakers talking about Educational Research saying, “When was the last time you heard of an educational study providing results that differed from the point of view of the organization who sponsored the study?” His point was that people “craft” research or use manipulative analysis to back up what they already think (or what benefits them or their organization).
As harmful as that can be in public education, it seems to me to be potentially so much more harmful in public health. I so appreciate the clarity you bring to this issue and for helping to peel back the curtain on so many misleading pieces of information that we, who are the non-medical people, don’t know to believe or not.
Just embarrassing and ludicrous he is used as an expert. I swear he is gunning to be Long COVID Czar. It’s all about the Next Job, either pharma or government administration + keeping that 40+ million NIH funding he brings to Scripps: https://reporter.nih.gov/search/FKsGVQWcgUKcWOjjeYEoGg/projects
This ‘guy’ Eric Topol has been spewing the ‘Covid propaganda narrative’ for going on three years now...he’s been a ‘go to medical expert’ on local San Diego TV and other platforms since early 2020. (I live in San Diego and I’ve heard him...always thought he was a ‘lame expert’).
Wholeheartedly agree with the opinions shared here, but would caution against too much cross posting with sensible medicine. It shouldn't feel like an extension of anyone's personal blog.
Dr. Eric Topol is listed as the founder and director of the Scripps Research Translational Institute, whose “focus has been on the use of genomic and digital data, along with artificial intelligence.” This is a mash-up of trendy cliche words that add up to not much of anything. Topol is less a researcher than a “technology evangelist” in a lab coat.
he has also been tweeting clumsily about vaccine-induced myocarditis and was on Sam Harris's podcast pontificating about how vaccine-induced immunity is proven to be superior to that of natural infection.
Vinay, I accept your call for enduring and deeply rooted skepticism. It may well be that Paxlovid has an important place in our therapeutic arsenal as a treatment for COVID-19. We must be careful not to make ad hominem attacks on our colleagues. I think that you did fine on Topol. Keep up the good work.
A very important post today from Vinay. I say thanks so much for calling out this guy out in San Diego. Regrettable as it is, I think we are seeing repeatedly now a public exposure of folks who just don't know jack-shit about biostatistics, epidemiology, or clinical evidence analysis. Such persons can be very "dangerous" in a public health information transfer sense because while they may well be "famous in their own fields", they know just enough buzzwords, jingles, and BS to get their feet into their mouths on a regular basis. Keep tightening the screws on all purveyors of nonsense!
I have developed personal "rules of engagement" regarding whom to trust these days when watching TV news shows that interview this or that "expert on COVID". Here is a summary: The more oleaginous the person is, the higher I raise the bullshit deflector panels, and right away. If the person uses her/his hands constantly when talking, raise those panels another notch; if the person keeps saying stuff like "moving forward", "leaning into", "outward facing" , or "we are spinning up our teams right now", then raise panels five notches higher. Finally, if the person lapses *even once* into talking in the patois of the teenaged mall rats by saying the word "LIKE" over and over, turn off the TV and like leave the room because this crap will like finally poison your mind like permanently.
🤣👏🏼
After four decades on Wall Street I earned a hard nosed skepticism steeped in data. Imagine my surprise when I turned my retired focus on Healthcare and found those folks were just as self-interested?!?! And the political class...defense contractors...Big Food...ad nauseum. Are there no longer any ethical fiduciaries? As an independent thinker, I feel as vulnerable as a newly incarcerated San Quentin prisoner with no gang affiliation. It seems no one has our back.
I can rectify the healthcare business when I drop my foolish thoughts about businessmen caring about patients when I focus on the second word of healthcare business.
Even RCT’s can be rigged. Read the book “Turtles All The Down”. Shocking!
Great book for an intro to non-Covid vaccine trials lack of good safety data (nearly all trials done without a saline placebo; most RCT's used a "safe" vaccine as the placebo, so the "safety" was comparable).
Yes! A Great Book!
All I can say about paxlovid is that everybody I know who has been doubly boosted, then contracted covid and treated with Paxlovid has suffered rebound immediately upon finishing the 5 day course - and that includes the Bidens, Fauci and Wallensky herself. While Anecdotal it is 100% so far. And no surprise given that Paxlovid is virostatic and not virocidal.
No one has explained why physicians are not prescribing ten days of Paxlovid in light of the well-documented rebound phenomenon. That would require an "off label" prescription which is perfectly legal and common sense. I hope that a fellow reader can bring light to this idea. The FDA has no intrinsic legal power to prevent physicians from writing off label prescriptions. That was what so outrageous early in the pandemic when the FDA tried to intimidate physicians from writing prescriptions for hydroxychloroquine. That was outrageous and did not provoke much in the way of protest from practicing physicians.
I retired from a long career in pediatrics last summer. We pediatricians and specialists were forced to prescribe many of our "routine" meds off label as they were never fully studied or approved for pediatric patients. The right choice was to be familiar with the drug and its pros and cons and go ahead and prescribe.
I will give you an example. Tacrolimus is the most potent and commonly used immunosuppressant for solid organ transplant recipients around the world. Although it has never been approved for lung transplantation (presumably because additional studies would be too costly and lung transplant physicians are going to use it anyway), it is routinely used for kidney, liver and heart transplantation as well as lung transplantation. It has been approved for pediatric liver transplantation on the basis of a two published studies in which less than 200 subjects took the drug. Nevertheless, it is now used routinely in many infants and children who receive lung, heart, liver and kidney transplants. That is the state of the art and the law.
I know Eric; I have had to deal with him over many years. He has always been a fraud...not only in this area. But because he is at Scripps and has had his share of R1s (all incestuous as R1s are) people recruit him to write these ridiculous comments. He gets paid a fortune to go speak nonsense to health groups. It all speaks poorly of Scripps for sure.
Both Vinay and Topol write commentary for MedPage. How Vinay can stand to be on the same platform (and sometimes the same page) with Topol boggles my mind.
As an oncologist and principal investigator, our findings were never published on Twitter. The major flaw is posting on a platform that is not intended to generate scientific debate, only opinion, propaganda, fanaticism and conspiracy theories.
That last paragraph was my parting paragraph in my letter of resignation 5 years ago when attempting to leave the field of addiction - like an idiot my ego sent me back for two more years with hope that I could help the system I had worked for would wake up to patient care versus bottom line care...I knew better but had enough hope that things might be better. I was naive - and a colleague in ID said that my field wasn’t the only corrupted one. How naive I was...
I am sorry for all these types of examples, and concerned for all of us at either door.
The good news is that I’m in a position today to pay it forward and I still do the recovery work and help others...I just don’t charge and it ain’t pharma based recovery (pharma keeps a low bar very low)
Slight change of subject, but FWIW-----I remember seeing a tweet from Dr. Jha from the days before he was WH Covid czar, when he was still at Brown. He was commenting on something-or-other, and someone had been yelling about masks. He said that “masks help-----a little,” and went into some of the reasons that mask mandates are not the be-all and end-all that some folks think. I doubt that he would allow himself to make the same explanation today, as it’s a bit against the party line. I haven’t heard him comment on masks lately, and maybe he isn’t willing to speak about it, but surely his compatriots would be unhappy with him. Personal theory: Rochelle Walensky and pals pooh-pooh the Cochrane review because they are desperately trying to save face.
That’s their standard MO...block anyone that is ‘over the target’. So if one is ‘blocked’ that makes one’s ‘counter opinion’ null and void. 🤔🙄
Typical of that ilk - cuss and run away. Zero critical thinking.
Dr. Prasad:
I worked in public education for quite a few years and remember at a conference one of the speakers talking about Educational Research saying, “When was the last time you heard of an educational study providing results that differed from the point of view of the organization who sponsored the study?” His point was that people “craft” research or use manipulative analysis to back up what they already think (or what benefits them or their organization).
As harmful as that can be in public education, it seems to me to be potentially so much more harmful in public health. I so appreciate the clarity you bring to this issue and for helping to peel back the curtain on so many misleading pieces of information that we, who are the non-medical people, don’t know to believe or not.
Just embarrassing and ludicrous he is used as an expert. I swear he is gunning to be Long COVID Czar. It’s all about the Next Job, either pharma or government administration + keeping that 40+ million NIH funding he brings to Scripps: https://reporter.nih.gov/search/FKsGVQWcgUKcWOjjeYEoGg/projects
This ‘guy’ Eric Topol has been spewing the ‘Covid propaganda narrative’ for going on three years now...he’s been a ‘go to medical expert’ on local San Diego TV and other platforms since early 2020. (I live in San Diego and I’ve heard him...always thought he was a ‘lame expert’).
Wholeheartedly agree with the opinions shared here, but would caution against too much cross posting with sensible medicine. It shouldn't feel like an extension of anyone's personal blog.
Dr. Eric Topol is listed as the founder and director of the Scripps Research Translational Institute, whose “focus has been on the use of genomic and digital data, along with artificial intelligence.” This is a mash-up of trendy cliche words that add up to not much of anything. Topol is less a researcher than a “technology evangelist” in a lab coat.
he has also been tweeting clumsily about vaccine-induced myocarditis and was on Sam Harris's podcast pontificating about how vaccine-induced immunity is proven to be superior to that of natural infection.
LOL at that fucking tweet. Love you VP. You tell 'em.
Vinay, I accept your call for enduring and deeply rooted skepticism. It may well be that Paxlovid has an important place in our therapeutic arsenal as a treatment for COVID-19. We must be careful not to make ad hominem attacks on our colleagues. I think that you did fine on Topol. Keep up the good work.