The Wry Observer’s Covid-19 update (218): medical oxymorons and Settled Science

During the pandemic we became used to, and rather weary of the concept of following “The Science” but just as other terms take on unnecessary qualifiers “The Science” has now morphed into “Settled Science”. The term is of course absurd as any proper scientist will tell you, and I have added it to my list of oxymorons in medicine (read my book “Mad Medicine” for more). Settled Science is a useful term of approbation when trying to rubbish hypotheses, or proofs, that contradict it. It gives a spurious sense of finality in science but there are innumerable examples of how Settled Science is unsettled – and not only in medicine. Think Einstein and the theory of relativity, which was unsettled by the postulation and later discovery of the Higgs boson. Think Galileo and Copernicus, the fools on the hill (who saw the sun going down, but the eyes in their head saw the world spinning round – possibly the most profound Beatles song); William Harvey discovering the circulation; John Snow undermining the miasma theory of infection with his observations on the Broad Street pump; Semmelweis and puerperal fever; Pasteur and bacteria; the electron microscope and cellular pathology. And then there are the various examples of where it becomes apparent that the Settled Science is based on a falsehood; spinach and its iron content, forgetting the oxalic acid that chelates the iron, never mind the decimal point being in the wrong place in the initial calculations; discovering the real cause of peptic ulceration was a bacterium, Helicobacter pylori; thinking that rheumatoid arthritis had something to do with Epstein-Barr virus, when the results were due to a contaminated reagent; climate change statistics muddled by temperature measurements in conurbations, or most recently from a thermometer close to an air force runway where jets were taking off at full blast.

Science is never Settled. It takes but one contrary observation to knock down a long-held belief – the Black Swan principle. For example – coral bleaching as a sign of global warming. It can be a local phenomenon and nothing to do with fossil fuel burning but relating to the warming events of underwater volcanic eruptions, as last year in the Pacific. And a quick question: has the bleaching in the Great Barrier Reef continued inexorably to progress? Actually no; indeed it appears to have reversed. The Settled Scientists prefer to ignore such observations that contradict them, just as they have been downplaying the growing evidence that SARS-CoV-2 vaccines cause harm. This is not science, but dogma, back to the days of the Inquisition. It is not good. So I beg readers not to use the term Settled Science ever again.

The Wry Observer’s Covid-19 update (217)

Today “Trust the Evidence”, the blog of Drs Heneghan and Jefferson, asks whether the pandemic is over, to which I responded:

“The pandemic is over. No-one seems to worry about it except politicians and the WHO. Here in my small town people toss out the fact they have Covid as if it were no more than a cold – which of course it isn’t, whether because of vaccination (doubtful) or viral mutation to a milder form (highly likely). So yet again I ask the question: does a pandemic infection really matter if it doesn’t kill people? It’s rhetorical really, because the answer is no. Do you need to stop transmission of a mild non-fatal virus? No. Do you need to rapidly identify, and appropriately treat, people who get the virus and then, for reasons of genetics, obesity and other such, get very ill (aka Covid-19, cytokine storm, hyperimmune state)? Yes. And yet all the noise is about stopping transmission. As this is impossible let’s simply concentrate on the suddenly seriously sick, which is a relatively simple task. The same applies to future pandemics. And while we are about it let’s ban modelling because of the GIGO principle (garbage in, garbage out).

It irks me greatly that those in charge continue to rely on the wrong experts. If I needed a hip replacement I would not ask a neurosurgeon, so why, when confronted with a serious medical condition like Covid-19, normally treated by physicians and intensivists, are we relying on experts in statistics, virology, public health and epidemiology? Their solutions are unravelling faster than a roll of toilet paper by the Andrex puppy.”

Their article is worth reading, and can be found at https://trusttheevidence.substack.com/p/a-round-up-of-recent-tte-posts-and?utm_source=post-email-title&publication_id=1029183&post_id=116930775&isFreemail=false&utm_medium=email

At the same time I criticised a BMJ update “A living WHO guideline on drugs to prevent covid-19” (https://doi.org/10.1136/bmj.n526) which is, I think, a red herring, oxymoron or whatever, not least as it repeats the fallacy that SARS-CoV-2 infection and Covid-19 are synonymous, but particularly because its main purpose is the continuing discreditation of hydroxychloroquine. So I wrote:

“It is regrettable that this article will serve only to confuse both medical and lay readers.

I have made the point many times that confusion arises from the improper interchangeability of the terms “SARS-CoV-2” and “Covid-19”. They are not the same. Covid-19 is a specific syndrome of severe illness due to the induction of a hyperimmune state (cytokine storm, CSS) by infection with SARS-CoV-2. Thus preventing Covid-19 requires prevention of the development of that hyperimmune state. As the risk of such development depends on several factors (including genetic susceptibility) it is far from certain that SARS-CoV-2 infection will progress to Covid-19 and anyway the risk from more recent virus variants has clearly diminished substantially. But as one cannot predict in advance, the whole concept of preventing Covid-19 is an oxymoron and discussion of prophylaxis is a waste of time.

The vast majority of cases of SARS-CoV-2 infection develop little more than a bad cold or flu-like illness. So is the application of any antiviral drug actually necessary? I think not. What is necessary is a system for promptly identifying incipient Covid-19 (by measuring oxygen saturation in the first instance, and applying appropriate blood tests such as CRP, fibrinogen, D-dimer, platelet count etc) and then appropriately treating that developing cytokine storm with steroids and biologics. One could argue that hydroxychloroquine, a weak immune modulator, might have a role alongside these but none of the trials have employed it specifically in that capacity, and in any case if one was to extrapolate from its use in inflammatory joint disease one would use it in combination or not at all, as there are things that work better. So discussing the hydroxychloroquine evidence is also a waste of time.

SARS-CoV-2 infection is not the only thing that can precipitate a cytokine storm and I remain baffled by the apparent failure of almost every commentator to realise this. We need a hard reset based on longstanding management of the syndrome – which in my view requires everyone to read Cron and Behrens’ textbook [reference given, but omitted here as I have mentioned it ad nauseam et infinitum]. The reaction to the appearance of SARS-CoV-2 was, in retrospect, one of panic and hysteria. Most people need no treatment. Those that do should have the correct treatment applied promptly.”

The Wry Observer’s Covid-19 update (216)

This morning I was returning from the butchers and followed a family of tourists up my cobbled street. The wife, who was walking ahead of her husband and the two children, turned and said “That’s Mermaid Street at the top”, whereupon the older child, aged five or six I suppose, said with great conviction “Ooh! Isn’t that where they sell mermaids? I’ve heard they do.”

Oh for the certainty of innocence and innocent certainty! On the coronavirus front the uncertainty mounts, and my prophecy that many of the accounts so far written were done too early is coming true. Those who said lockdowns were the only solution to transmission, and that the one in the UK should have been done earlier, have been confounded by the Swedish experience of no lockdown; the Swedish case rate was little different from the European lockdown countries. The apparent effectiveness of the Wuhan lockdown is attributed to its rigour. I am not so sure that is the reason for any difference and will go with the Scottish legal conclusion of “not proven”. Those who tried to blame the Wuhan wet market, and bats or pangolins in particular as the source of the virus, have been confounded by its apparent man-made nature, containing as it does an unnatural structure, namely a furin cleavage site, and there is ongoing debate (or conspiracy) that the viral samples were sent from the USA to Wuhan, whence it escaped from the laboratory. Some of the obfuscation surrounding events of late 2019 and early 2020, such as the sudden withdrawal of the Wuhan virus database and the strident protests of scientists later shown to have a major conflict of interest are certainly suspicious; new Chinese research might point to raccoons as a source (the virus has been found in market samples) but there’s nothing to suggest it could not have been humans infecting raccoons rather than the other way round. Masks were not recommended, then they were, then they were deemed ineffective after proper analysis of proper trials. Those who proposed using ivermectin were punished by the science community’s Inquisition. The spike protein vaccines are now deemed to be gene therapies which failed to prevent virus acquisition, have caused significant side-effects and appear ineffective against the newer virus variants, not to mention being a possible cause of “Long Covid” because subcellular organelles, or plasmids, were injected with the messenger RNA and so enabled cells to go on producing that M-RNA.

Uncertainty is rampant. And the spillover from the intense scrutiny of SARS-CoV-2 into rigorous analysis of the climate change data shows that there is increasing uncertainty about how real climate change actually is, quite apart from the argument that much of it is part of a natural cycle, is influenced more by natural events than by man’s carbon emissions and may not matter anyway if increased CO₂ levels help to green the planet. Most advancing this argument are labelled as deniers, just as those querying the value of coronavirus “vaccines” and statin sceptics are. But they aren’t. They are sceptics; no-one denies that the climate changes. It always has. Think where the sea levels were in Roman times. Remember that the eruption of Krakatoa in 1883 caused a worldwide 0.4^oC cooling which lasted for several years; that the reversal of the 16^th Century mini Ice Age began long before industrialisation could have contributed; that the desertification of the Sahara was caused by goats overgrazing; and that the disappearance of the Aral Sea was caused by water diversion, not by industrial emissions. On the statin front they do work in reducing cardiac mortality (but not a lot) but because they are anti-inflammatory, not because of their cholesterol-lowering effect which is an epiphenomenon. It’s vital to look at cause and effect; the reduction in SARS-CoV-2 virulence is due to mutation, not to vaccination. The differential risk of the original virus progressing to Covid-19 in certain ethnic groups was to do with genetics, not racial discrimination.

It is valuable to look at the “Spanish Flu” pandemic of 1918, as Mark Honigsbaum has done in detail. The infallible retrospectoscope reveals many parallels with SARS-CoV-2. Its very name is wrong, as it almost certainly originated in the USA. It was misdiagnosed as a bacterial infection because samples often found Haemophilus Influenzae, although test results were often anomalous, and a one-off experiment proving it wasn’t, was overlooked. There was a clear disparity in mortality between racial groups. Spread was driven by immune profile and crowding; the clinical features of severe and fatal illness fit best with a cytokine storm syndrome, but many people were entirely unaffected. Nonetheless there was widespread panic.

Doesn’t a lot of this sound familiar? It makes it all the stranger than the WHO intends to force governments worldwide, in the event of another pandemic, to adopt measures that at best are questionable and at worst are useless. It also makes it all the more important in the UK that the Hallett Inquiry is not rushed. But I would like to understand why scientists and politicians will never admit that they were wrong, and/or find excuses not to apologise.