Even today, most medicine and medical practices come from anecdotal learning. Treatment springs from opinion. Evidence-based medicine remains more myth than practice.
Scottish doctor Archie Cochrane turned his attention to epidemiology in the 1960s. Looking at health care systems in 18 economically developed nations, he found health care a crap shoot, to the extent that doctors were as likely to cause death as not. “There is a marked positive association between the prevalence of doctors and mortality in the younger age groups,” Cochrane concluded.
The term “evidence-based medicine” was only coined in 1991. Its pretense has only been felt in the wake of the covid pandemic which struck in 2020.
The problem with medical evidence is the paradox that there is paucity of it amid a flood. Clinical studies are private investigations (even when government-funded) without coordination to what has already been done. Key questions go unaddressed, and thereby unanswered.
Public health authorities clamored for intel on how to deal with covid outbreaks. The disease provided a focus to medical research. But the methodology remained broken. “You have this huge amount of inappropriate and probably wasteful duplication of effort,” observes Canadian medical researcher Grimshaw. “There’s a fundamental noise-to-signal problem.”
Medical researchers grasp of statistics is slight. The spotty semi-redundancy among similar studies has led to the rampant use of meta-analyses: combining statistically insignificant data and declaring it valid by dint of the illicit law of large numbers.
Early on in the pandemic, epidemiologists ignored evidence that V2’s contagion vector was primarily airborne, concentrating instead on fomite (surface) transmission – a possibility which was backed by evidence, though its probability never decently assessed. This resulted in a massive futility of cleaning surfaces which had little chance of ever being a source of covid contagion.
Face masks exemplify a bad public policy decision based on facile reasoning – which is, basically, treating everyone as if they are diseased, and that a visible show may magically reduce contagion.
Medical-quality masks have been shown in laboratory tests to reduce aerial transmission of viruses by some 60%. Lesser masks are much less effective.
The most important medical fact about masks is they do next-to-nothing to prevent being infected by V2, the virus behind covid: foremost, because the virus readily enters through the eyes. V2 can also penetrate through the skin.
The most important economic fact about masks is that not enough medical masks can be produced to have everyone wear one. And those masks are not cheap.
The most important environmental fact about masks is that they are disposable, are made with toxic chemicals, and thereby pose a significant pollutant.
Defying decent evidence-based decision-making, mask-wearing became mandatory throughout much of the world. Mask litter has become a common sight, while covid contagion has gone unchecked from this futile but wasteful gesture.
What has been shown the most effective measure to thwart covid spread is mass testing on a frequent basis. Inexpensive antigen tests have been developed which give rapid results. China and South Korea have used these and other V2 viral tests to considerable effectiveness. Ignoring the evidence, most of the countries in the West have done only cursory testing.
The first flu vaccines were administered to American civilians in 1946. The side effects were often as bad as being infected – leading many to assume that they caught the flu from the vaccine. Further, early flu vaccines only worked on 1 of 3 different varieties of flu. Early flu vaccines were a flop.
In 1976, a swine flu outbreak hit New Jersey, inciting panic of a new pandemic. US president Gerald Ford announced that the federal government would vaccinate all Americans. The vaccine developed to fight the flu caused nerve damage and paralysis in many, leading to fear of vaccination. The mass jab campaign was aborted.
Flu vaccine development continued. Promotion by the US federal government and lack of negative publicity has resulted in many assuming that the vaccines are safe and effective. Evidence of that is somewhat lacking.
There had never been a vaccine for the common cold. The vaccines for covid were the first.
Healthy people don’t get sick from the V2 virus. Covid is a mild cold at worst.
‘Severe’ covid, as it is called, is an autoimmune disease. The only people at risk from covid are those who have not kept themselves healthy. Covid is a comeuppance for the overweight, self-indulgent majority. The evidence for that conclusion is abundant.
Sensing a profit bonanza, commercial drug makers set their sights on rushing jabs to market. The result was hasty testing of hazardous concoctions.
Pfizer was first to cash in, claiming an outrageous efficacy based on rigged statistics. Like early flu jabs, side effects were considerable: in many instances, far worse than the disease itself.
Other V2 vaccine makers piled in as quickly as they could – after hasty testing that nonetheless passed desperate-government muster. Time and again, the outcomes from commercial makers were serious side effects – sometimes lethal.
Among the vaccines which proved safest were those from China, based upon the traditional technique of using an inactive virus, rather than more radical endeavors in the West, based more on theory (speculative opinion) than evidence. Unlike Western profit-seekers, China was in no hurry to peddle an unsafe vaccine internationally – realizing perhaps its reputation was at stake. Evidence-based medicine is, after all, cautionary.
V2 is a saltational virus – a wily evolutionary leap to begin with, and ambitious in constantly adapting itself for greater contagion. The evidence is that vaccines will never stop covid.
What the vaccines have been shown to do is limit severe covid in those most at risk of that disease outcome. For this group only, the risk of side effect is outweighed by its insurance value.
Yet Western governments are now promoting V2 vaccines as a panacea to eliminate covid through mythical herd immunity – a flagrant example of medicine by wish, with no evidentiary support. The bettter program would be to promote the self-discipline of physical and mental health, the techniques for which are well established.
Not following the evidence, governments imposed futile restrictions which impoverished economies, incited social conflicts, and inspired mental health crises – but did not limit outbreaks.
Covid has been a stress test of evidence-based medicine. The failure is in evidence.
Reference:
Trisha Greenhalgh, “Will COVID-19 be evidence-based medicine’s nemesis?” PLOS Medicine (30 June 2020).
Helen Pearson, “How COVID broke the evidence pipeline,” Nature (12 May 2021).
Ishi Nobu, “Covid vaccines.”