"I am the science." With that attitude, who needs data? Before the pandemic, my attitude toward the CDC, FDA, Big Pharma, etc. was "they're not perfect, but I'll generally give them the benefit of the doubt." How wrong I was. I no longer have any confidence in their policies and pronouncements. Unfortunately, this extends to some of my personal health care providers who continue to hold these policies as gospel either because they believe them or have to in order to keep their job. I'm not sure which reason is more disappointing.
Right. They had no incentive. Media was happy to run their claims without any evidence. If they tried to go GET evidence, there was a real risk the data would indicate their claims were wrong. So, in a sense, the logical move for them was not to go do science.
They ran none because all previous studies showed no significant effect for community measures, because "community" measures are never applied at home and that's where most transmissions occur...
Thank you for the article. I couldn't agree more, and they need to be defrocked. While all this nonsense has been going on, it might be more useful to name names. Certainly for anyone who knows some of the major players, the name Anthony Fauci would be prominent. And while the CDC was a complete bust (which just about anyone with a scintilla of discrimination or knowledge of by whom and how the CDC is constituted) there have been a lot of usable studies which, for instance, can statistically tell us that masking was pretty much useless, as were a whole range of "dumb ass" public health responses: 6 ft. distancing, school closures, vaccine mandates, repeated vaccinations, delicensing, idiot laws against repurposed drugs, wave after wave of fear porn, and my personal favorite---doctors who by the millions refused to look at any evidence whatsoever, sending thousand to their deaths. Like the propagandistic approach to the waves of fear porn, I think repeating the names and crimes of the perpetrators, over and over and over, would be useful. To not do so may be more kind and forgiving, but it's also bringing a knife to a gun fight.
What do they even do? All this time to prepare for something like this, centers for disease control? Really?! Protocols moving forward on what they have learned? Nope.
that and also, they have failed at every stage, if that is what science is, non-stop failure, then science doesn't work (science does work, but science doesn't happen when people can't say and do their own thing, science can't exist without liberty, that's why the enlightenment and liberalism have been so successful, because they enable science, collectivism destroys them all)
Vinay, Please give a simple example of such a cluster RCT you have been recommending. How would it be different from the usual RCT with large sample size. Would statistical analysis be different or easier?
Dr. Prasad, I would love to get your take on this Cochrane Review of randomized controlled trials and observations studies. It seems to me that during a pandemic, understanding this may have been really beneficial to public health policy makers.
TL;DR: "Our results provide little evidence for significant effect estimate differences between observational studies and RCTs, regardless of specific observational study design, heterogeneity, inclusion of pharmacological studies, or use of propensity score adjustment. Factors other than study design per se need to be considered when exploring reasons for a lack of agreement between results of RCTs and observational studies."
At issue has been Dr Fauci's insistence (wrongly) that only RCTs matter. Of course that pushes things in the direction of pHarma funding of such typically expensive studies. The resultant patented drugs then can produce royalties that often accrue to the NIH budget and NIH researchers in a blatant conflict of interest.
The generic NIH funded RCTs seem from the outset designed to fail, not sure why. But several obvious RCTs on important topics were not funded at all which is Dr Prasad's complaint.
As Dr Atlas revealed - he arrived to meetings armed with papers to discuss with the technical staff who were not prepared to address the science. They were all about policy matters. So very odd that the technical staff were so ill informed, seemingly uninterested. Policy making is the power to influence and direct the public and should only be made by those accountable for those policies - by Congress representing the public. Seems like the technical advice was opinion rather than science despite all of Dr Fauci's posturing. Then groupthink took over to even eliminate any debate. Now I can't be sure of all that because I wasn't there so depend on observers like Atlas. Still I can't begin to understand how our officials did so poorly despite much funding.
Then Dr Brix complained about the data arriving to be interpreted. Three years in and we STILL don't have an adequate system of collection nor analyses. And now it seems there are efforts to even hide data that doesn't adhere to assumptions. The essence of science rests on refinement of data, development of new hypothesis to understand that data. We seem to have abandoned that and witness the failure of public health policy.
Clearly the CDC is run by people with a very special combination of skills rarely pulled together so effectively. Sadly those are hubris, incompetence and delusions of grandeur. The result wasn’t simply that they didn’t use the opportunity to learn something, contribute to science and help save lives. Instead, they published garbage, became a source of derision and misleading direction that has contributed significantly to loss of life and the unnecessary continuation of fear of simple unknowns.
I would love for the next CDC director to fire EVERYONE and then have them reapply for their job. Hire about half the people that were there before b/c the ones you hire will be intelligent. Then you can pay them MORE. Also make each currently fired employee explain WTH happened with Covid and their thoughts on why their institution failed so badly.
It would be a reasonable thing for them to do, I'm just pointing out that that would be asking them to change their mission mid-public health crisis, and mid-budget cycle. Hard to run a trial without budget for it.
I guess the real critique is that there was not a war chest set aside to run these trials when the need arose. Like you, I sure wish there were. But that seems more a critique of the short-sightedness of representative democracy in general than of the CDC per se.
Interesting point. Don't they run the trials/write the studies they post in the MMWR? Even if you're right, their interpretation of observational studies is pathetic!
"I am the science." With that attitude, who needs data? Before the pandemic, my attitude toward the CDC, FDA, Big Pharma, etc. was "they're not perfect, but I'll generally give them the benefit of the doubt." How wrong I was. I no longer have any confidence in their policies and pronouncements. Unfortunately, this extends to some of my personal health care providers who continue to hold these policies as gospel either because they believe them or have to in order to keep their job. I'm not sure which reason is more disappointing.
Right. They had no incentive. Media was happy to run their claims without any evidence. If they tried to go GET evidence, there was a real risk the data would indicate their claims were wrong. So, in a sense, the logical move for them was not to go do science.
As I note in my post, the technocrats preferred to dabble in policy rather than data.
100%. they know what the results would show.
They ran none because all previous studies showed no significant effect for community measures, because "community" measures are never applied at home and that's where most transmissions occur...
The CDC should be dismantled, and all 20K employees sent home. They are an affront
Bad Cattitude just did an excellent post on this. The CDC is woo-woo. They are done.
Thank you for the article. I couldn't agree more, and they need to be defrocked. While all this nonsense has been going on, it might be more useful to name names. Certainly for anyone who knows some of the major players, the name Anthony Fauci would be prominent. And while the CDC was a complete bust (which just about anyone with a scintilla of discrimination or knowledge of by whom and how the CDC is constituted) there have been a lot of usable studies which, for instance, can statistically tell us that masking was pretty much useless, as were a whole range of "dumb ass" public health responses: 6 ft. distancing, school closures, vaccine mandates, repeated vaccinations, delicensing, idiot laws against repurposed drugs, wave after wave of fear porn, and my personal favorite---doctors who by the millions refused to look at any evidence whatsoever, sending thousand to their deaths. Like the propagandistic approach to the waves of fear porn, I think repeating the names and crimes of the perpetrators, over and over and over, would be useful. To not do so may be more kind and forgiving, but it's also bringing a knife to a gun fight.
I would love to see the CDC mask study on mice!
I was hoping to be the one to make this joke but you beat me to it!
Hope the CDC reads this.
I have wondered if staff are told not to follows nor comment on these pages. There must be some who really are honorable stewards of science.
What do they even do? All this time to prepare for something like this, centers for disease control? Really?! Protocols moving forward on what they have learned? Nope.
that and also, they have failed at every stage, if that is what science is, non-stop failure, then science doesn't work (science does work, but science doesn't happen when people can't say and do their own thing, science can't exist without liberty, that's why the enlightenment and liberalism have been so successful, because they enable science, collectivism destroys them all)
Vinay, Please give a simple example of such a cluster RCT you have been recommending. How would it be different from the usual RCT with large sample size. Would statistical analysis be different or easier?
It would be worth an entire sub stack.
Dr. Prasad, I would love to get your take on this Cochrane Review of randomized controlled trials and observations studies. It seems to me that during a pandemic, understanding this may have been really beneficial to public health policy makers.
https://www.cochrane.org/MR000034/METHOD_comparing-effect-estimates-of-randomized-controlled-trials-and-observational-studies
Very interesting - thanks for posting.
TL;DR: "Our results provide little evidence for significant effect estimate differences between observational studies and RCTs, regardless of specific observational study design, heterogeneity, inclusion of pharmacological studies, or use of propensity score adjustment. Factors other than study design per se need to be considered when exploring reasons for a lack of agreement between results of RCTs and observational studies."
At issue has been Dr Fauci's insistence (wrongly) that only RCTs matter. Of course that pushes things in the direction of pHarma funding of such typically expensive studies. The resultant patented drugs then can produce royalties that often accrue to the NIH budget and NIH researchers in a blatant conflict of interest.
The generic NIH funded RCTs seem from the outset designed to fail, not sure why. But several obvious RCTs on important topics were not funded at all which is Dr Prasad's complaint.
Makes sense.
And even if RCTs aren't the only valid epistemological process, it certainly can't hurt to conduct the handful that Dr V suggests.
As Dr Atlas revealed - he arrived to meetings armed with papers to discuss with the technical staff who were not prepared to address the science. They were all about policy matters. So very odd that the technical staff were so ill informed, seemingly uninterested. Policy making is the power to influence and direct the public and should only be made by those accountable for those policies - by Congress representing the public. Seems like the technical advice was opinion rather than science despite all of Dr Fauci's posturing. Then groupthink took over to even eliminate any debate. Now I can't be sure of all that because I wasn't there so depend on observers like Atlas. Still I can't begin to understand how our officials did so poorly despite much funding.
Then Dr Brix complained about the data arriving to be interpreted. Three years in and we STILL don't have an adequate system of collection nor analyses. And now it seems there are efforts to even hide data that doesn't adhere to assumptions. The essence of science rests on refinement of data, development of new hypothesis to understand that data. We seem to have abandoned that and witness the failure of public health policy.
Great post. The failure was systemic. Where and how to reassemble the pieces of public health?
Clearly the CDC is run by people with a very special combination of skills rarely pulled together so effectively. Sadly those are hubris, incompetence and delusions of grandeur. The result wasn’t simply that they didn’t use the opportunity to learn something, contribute to science and help save lives. Instead, they published garbage, became a source of derision and misleading direction that has contributed significantly to loss of life and the unnecessary continuation of fear of simple unknowns.
I would love for the next CDC director to fire EVERYONE and then have them reapply for their job. Hire about half the people that were there before b/c the ones you hire will be intelligent. Then you can pay them MORE. Also make each currently fired employee explain WTH happened with Covid and their thoughts on why their institution failed so badly.
The CDC runs trials? Since when? Example?
It would be a reasonable thing for them to do, I'm just pointing out that that would be asking them to change their mission mid-public health crisis, and mid-budget cycle. Hard to run a trial without budget for it.
I guess the real critique is that there was not a war chest set aside to run these trials when the need arose. Like you, I sure wish there were. But that seems more a critique of the short-sightedness of representative democracy in general than of the CDC per se.
Interesting point. Don't they run the trials/write the studies they post in the MMWR? Even if you're right, their interpretation of observational studies is pathetic!
Yes