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Hydroxychloroquine and COVID-19: Science-based medicine has no chance against Donald Trump, Peter Navarro, and Dr. Oz

President Trump’s COVID-19 advisors include Dr. Oz, Rudy Giuliani, and Peter Navarro, the latter an economist who thinks he can science better than Anthony Fauci. Can science- and evidence-based medicine prevail with respect to hydroxychloroquine and coronavirus?

I hadn’t planned on writing about the overblown promotion of antimalarial drugs like chloroquine and hydrochloroquine to treat COVID-19 so soon. After all, there’s very little in the way of new science. The state of our knowledge about whether hydroxychloroquine might be a useful treatment for COVID-19 is basically unchanged since Friday. Unfortunately, over the weekend, the quackery-promoting right wing noise machine, led by President Trump, went into high gear promoting this unproven drug as a treatment for coronavirus. I also learned more about the sources influencing Trump to do this, primarily Peter Navarro, Rudy Giuliani, and—who else?—America’s quack Dr. Mehmet Oz.

But first, witness a most disturbing scene:

President Trump spent a portion of Sunday’s press briefing yet again promoting an unproven treatment for the novel coronavirus, repeatedly asking, “What do we have to lose?”

So toward the end, a CNN reporter turned to Anthony S. Fauci, the government’s top infectious disease expert, for his opinion on the effectiveness of hydroxychloroquine with a sharper question: “What is the medical evidence?” Standing at the microphone, Fauci opened his mouth — but before he could speak, the answer came out of Trump’s instead.

“Do you know how many times he’s answered that question?” Trump cut in. “Maybe 15.”

A tight smile stretched across Fauci’s face. His eyes, framed by a pair of wire-rimmed glasses, flicked quickly to Trump. He glanced back at the reporter, who was saying to the president, “The question is for the doctor. … He’s your medical expert, correct?”

Fauci’s smile, for just a moment, was all teeth now. Trump raised his finger sternly, telling the journalist, “You don’t have to ask the question,” and so Fauci didn’t answer it, and the news conference shuffled right along.

The video that accompanies the story I’m quoting was literally painful for me to watch. Basically, President Trump jumped in after the reporter asked Dr. Fauci the question and told him not to answer, and he didn’t answer. Meanwhile, during the press conference:

But the president cut Fauci off before he could clarify his viewpoint during today’s conference.

“There are signs that it works on this [coronavirus],” Trump told reporters, citing “strong and powerful signs” it worked. “It’s been around a long time.

“I’m not acting as a doctor, I’m saying ‘do what you want,’ but there some good signs.”

“If it doesn’t work, nothing is lost by doing it,” he added. “I want to save lives – I don’t wanna be in a lab for the next year-and-a-half.

“It can help them but it’s not going to hurt them.”

Wrong, Mr. President:

In a story from Sweden (translated with Google Translate, which did surprisingly well with Swedish):

On March 23, Carl Sydenhag tested positive for the coronavirus after having a fever and breathing difficulties. At Södersjukhuset in Stockholm he received antibiotics intravenously and chloroquine.

“I was prescribed to take two tablets in the morning and two in the evening,” says Carl Sydenhag.

Here’s what happened next:

“I got cramps and a headache that I have never had before. It felt like I had stepped into a high voltage plant.”

Carl Sydenhag says that his vision was also affected and that his peripheral vision was reduced. He then decided to read the package leaflet and saw that the side effects he experienced usually occurred in one in 100 taking the medication.

“Then I called the Poison Information Center that said the dose I had been given was dangerous, so I stopped taking the tablets and went to the hospital again.”

Once at the hospital, doctors thought that Carl probably received an excessive dose of the medication.

Today, he no longer has any symptoms for covid-19, but thinks that his vision is still worse than usual and that he still feels dizzy.

“But I feel much better than I did before. It may have been that the malaria medicine helped against the corona and I am very grateful for that, but you have to dose correctly,” says Carl Sydenhag.

As a result:

Chloroquine has been given to covid-19 in several hospitals in Sweden. But last week, all hospitals in the Västra Götaland region stopped using it.

“There were reports of suspected more serious side effects than we first thought. We cannot rule out serious side effects, especially from the heart, and it is a hard-dosed drug. In addition, we have no strong evidence that chloroquine has an effect at covid-19,” says Magnus Gisslén, professor and chief physician at the infection clinic at Sahlgrenska University Hospital, to the Gothenburg Post.

More detail can be found in this story:

“We might have made another assessment if covid-19 was a disease with very high mortality, for example 80 per cent dead, but now we can manage most people who are intensive care anyway,” says Magnus Gisslén.

He is self-critical that he let himself be drawn into the chloroquine.

“In retrospect, I can regret that we did. We were a bit naive and thought the side effect profile was much better. I have changed my mind and hope that the rest of the country does too.”

Certainly the story above is only anecdotal. We don’t yet have good data on how widespread adverse events from these drugs have been in COVID-19 patients. Nonetheless, it’s plausible. I’ve been warning of this sort of outcome for weeks now, ever since the craze for chloroquine and hydroxychloroquine swept the world and became the latest bright, shiny object to attract the attention of our scientific ignoramus of a President.

After all, it’s long been known that hydroxychloroquine can affect the cornea. Specifically, the drug can cause the formation of deposits on the cornea that begin “as diffuse punctate deposits that, over time, aggregate into curved linear whorls, becoming irregular and branching and involving the pupillary zone.” These deposits are usually reversible with cessation of the drug, but it can take up to a year for them to resolve. Worse, prolonged use can cause a characteristic retinopathy, an effect that is often not reversible. It’s the reason why lupus patients taking the drug must undergo regular ophthalmological examinations. It’s also long been known that these drugs can affect the heart, prolonging the QT interval on EKG and in uncommon cases cause a potentially fatal arrhythmia known as Torsades de Pointes. This risk is exacerbated when these drugs are combined with azithromycin. The law of large numbers means that, even if these serious adverse reactions are very uncommon, if millions of people start taking the drugs, many thousands will be harmed with no good evidence of benefit to outweigh the harm.

We all know that Donald Trump is very impressionable, often basing decisions on advice or information he got from the last person he talked to. So whom is he talking to? Is it any surprise that one of these people is Dr. Mehmet Oz? Of course it’s not:

But Trump has told officials that it would be “a good idea” if they talked to Oz, one of the sources added. Top administration officials, including Trump’s administrator of the Centers for Medicare and Medicaid Services, Seema Verma, have privately spoken to Oz in recent days to discuss the virus and his views on the possible treatment, three sources said. The New York Times first reported that Oz had been in touch with the Trump team.

Oz seemed to confirm his level of access to the administration during an interview with Fox & Friends hosts last week, saying an “astute question” that co-host Brian Kilmeade asked the other day “on this show” actually inspired him to contact Verma about using the Medicare and Medicaid national data to compare coronavirus infection rates in patients already prescribed hydroxychloroquine versus patients who are not taking the drug.

“It’s a rough-and-tumble study, but she’s agreeing to do it, or look into it, anyway,” Oz claimed.

In this case, “rough and tumble” almost certainly means crappy and pointless. In the absence of widespread testing, any such study is likely to be uninformative, particularly given that there are likely to be so many confounders that it will be impossible to control for them all, not the least of which is simple geography. After all, some areas of the country are COVID-19 hotspots right now; others so far have been much less affected.

Of course, it’s no surprise that Trump would have an affinity for Dr. Oz, a.k.a. America’s quack. The two are very much alike: hucksters, showmen, con men. It’s not for nothing that I referred to their relationship as a “huckster bromance.”

Another conspiracy monger who’s been pushing hard to persuade Trump to promote these drugs is Rudy Giuliani, who years ago fully joined the tinfoil hat brigade and has cast himself in a new role, as the President’s personal science advisor (I know, try not to gag):

However, Giuliani said he has spoken directly to Trump “three or four times” about a potential coronavirus treatment, describing to him the results of an initial small-scale study in France that suggested the anti-malarial drug hydroxychloroquine may help treat covid-19. Giuliani said he has not spoken to other White House officials about his views.

He’s also been all over Twitter promoting the drugs, as well as talking them up on his podcast. It got so bad that Twitter even deleted one of his Tweets and temporarily locked his account for spreading coronavirus misinformation by saying that hydroxychloroquine “in at least three international tests was found 100% effective in treating the coronavirus.” Of course, even the most generous interpretation of those three execrable studies doesn’t support that statement. Giuliani is an equal opportunity quackery supporter, though. He’s also been promoting the use of “placenta killer cells” in a stem cell treatment for COVID-19 on social media and on his podcast.

Peter Navarro
Peter Navarro

Finally, there was a terrifying article published by Axios over the weekend describing an “epic” battle over chloroquine and hydroxychloroquine:

Toward the end of the meeting, Hahn began a discussion of the malaria drug hydroxychloroquine, which Trump believes could be a “game-changer” against the coronavirus.
  • Hahn gave an update about the drug and what he was seeing in different trials and real-world results.
  • Then Navarro got up. He brought over a stack of folders and dropped them on the table. People started passing them around.
  • “And the first words out of his mouth are that the studies that he’s seen, I believe they’re mostly overseas, show ‘clear therapeutic efficacy,'” said a source familiar with the conversation. “Those are the exact words out of his mouth.”
Navarro’s comments set off a heated exchange about how the Trump administration and the president ought to talk about the malaria drug, which Fauci and other public health officials stress is unproven to combat COVID-19.
  • Fauci pushed back against Navarro, saying that there was only anecdotal evidence that hydroxychloroquine works against the coronavirus.
  • Researchers have said studies out of France and China are inadequate because they did not include control groups.
  • Fauci and others have said much more data is needed to prove that hydroxychloroquine is effective against the coronavirus.
  • As part of his role, Navarro has been trying to source hydroxychloroquine from around the world. He’s also been trying to ensure that there are enough domestic production capabilities inside the U.S.
Fauci’s mention of anecdotal evidence “just set Peter off,” said one of the sources. Navarro pointed to the pile of folders on the desk, which included printouts of studies on hydroxychloroquine from around the world.
  • Navarro said to Fauci, “That’s science, not anecdote,” said another of the sources.

The Dunning-Kruger is so strong in this administration that an economic advisor like Navarro thinks he can science better than Anthony Fauci! It’s even worse than that. Watch this four minute clip, if you dare:

First off, Navarro’s arrogance of ignorance is so extreme that he refers to his view as a “second opinion” to that of Dr. Fauci. I suppose that, literally, it is an “opinion,” but it’s an uninformed and ignorant one from someone who has no clue about clinical trial design. Next, contrary to Navarro’s claims, there are not “numerous studies” on these drugs and COVID-19. There just aren’t. I’ve documented the pathetic handful of studies that currently exist and why they don’t provide a strong signal of efficacy for hydroxychloroquine. Hilariously, Navarro then touts his qualifications as a social scientist with a PhD and he “understands how to read statistical studies, whether it’s in medicine and law.” (His PhD is in economics, which certainly doesn’t qualify him to interpret clinical trial and biomedical study data.) I would counter that, whatever Navarro might have learned about statistics during his studies, he appears to have forgotten if he thinks the studies supporting the use of hydroxychloroquine are strong.

When I first watched the video, I was happy to see John Berman pushing back, countering by saying that none of that qualifies Navarro to treat patients. Navarro does mention that nearly every COVID-19 patient in New York receives hydroxychloroquine. Sadly, that’s true. However, Berman cleverly pushed back some more by quoting doctors actually using the drug and pointing out that they told him that they don’t know if it works, contrasting their uncertainty to Navarro, “as a social scientist with no medical training” (a delightful twist of the knife), claiming that it definitely does. In response, Navarro basically backs off and retreated to JAQING off, and claiming that he never said that hydroxychloroquine definitely worked. As for me, I can attest that doctors I’ve communicated with using hydroxychloroquine to treat patients tell me that they are unimpressed and don’t think it works. Certainly, they have seen no dramatic effects.

As I’ve described before, the infatuation of the medical profession with hydroxychloroquine based on a dubious observation in Wuhan based on small numbers in January that patients with lupus don’t get COVID-19, anecdotes from China that led to an “expert opinion” that was widely adopted in numerous other countries, and a handful of negative or equivocal studies so flawed that they are uninformative has led to hydroxychloroquine becoming, in essence, standard of care for COVID-19. This has been an epic failure of science- and evidence-based medicine. This was true before the right wing noise machine latched on to these drugs.

Unfortunately, now that Trump propagandists and the usual bunch of scammers and grifters have glommed on to promoting these drugs as a “game changer” and the “beginning of the end of the pandemic,” the hope that evidence-based medicine will be allowed to do its work looks increasingly grim. Indeed, I predict that, even if doctors can now get enough patients to agree to possibly being randomized to a placebo in the face of all the media messaging that these drugs work and sufficiently powered clinical trials are negative, no one will believe them, and the same grifters will proclaim the results a conspiracy to keep evidence of a “cure” for COVID-19 from the people.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

102 replies on “Hydroxychloroquine and COVID-19: Science-based medicine has no chance against Donald Trump, Peter Navarro, and Dr. Oz”

I would love to hear what you think about the idea that BCG vaccine might reduce mortality from COVID that’s been going on around here for a few days.
Probably just wishful thinking, as most of people in my generation and older proudly bear the scar on our forearms and correlation does not equal causation, but still…

Thanks for all your effort to stand up to what passes for “news”. It’s appalling that CNN would give any of these creeps air time. I’m sheltered from all that by not having TV, so I live in a bubble of sorts. Know that you are included in my 7 pm pot banging!

Something I have noticed about economists, even those with Ph.D.’s: Many of them[1] fall in love with their models, and persist in using them when there is no empirical support (even, sometimes, when empirical evidence contradicts them), or without verifying the underlying assumptions. We see the same thing here: Navarro has fallen in love with a model that says that hydroxychloroquine is a safe and effective treatment for COVID-19, never mind the evidence that it is not safe, nor the dubious evidence of its efficacy.

As for Navarro’s remarks about knowing statistics: I am a Ph.D. physicist who, in the course of my research, have had to acquire some knowledge of statistics. Here is what that knowledge of statistics qualifies me to do with respect to the medical literature: it allows me to spot certain kinds of obviously bad science, e.g., claims supported by insufficient statistics, as such. It does not allow me to say, of my own knowledge, that any given paper is a solid result, as there are many ways for a paper to go wrong that I am not qualified to spot. (There is also the issue of fraud, which is difficult for peer review to spot because peer review assumes good faith on the part of the participants.) The same applies to Navarro: if he really understands statistics, he should be able to spot that kind of problem with a medical paper, but he cannot say that any given paper is a solid result.

[1]There are good economists out there. Paul Krugman and Brad DeLong are the two I am most familiar with. I am a regular reader of DeLong’s blog, and he at least is willing to change his priors when shown good evidence that they are wrong. But too many economists are shills for whomever is paying their salary.

Stastician here, with an old roomate who has his Ph.D in economics. He’s one of the first to admit that far too many of his peers are woefully blind to even basic statistics.

But for Navarro — I don’t believe for a second he’s being honest saying his training gives him the ability to understand these studies. He’s pushing for hydroxychloroquine use because Trump is doing so, pure and simple. He’s distracting from admitting his position is based on blind loyalty with this crap about his training, as it’s the perfect “my opinion is just as good as the opinions of people called experts” line the right has used forever.

Final comment about economists: Quote Investigator gives multiple tracebacks for this type of joke, but my favorite goes to Truman.

President Truman once complained about trained economists: “Whenever I ask their opinion, they say on the one hand, so-and-so; but on the other hand, so-and-so, On the one hand, — but on the other hand. I would like to meet an economist with one hand!“

Yeah. Well explaining statistics is a whole endeavour on its own. Really tough to explain basic things to people who fell in love with their models. Met quite a number of people who berate statistics because “science is not only statistics”. They simply omit to mention or fail to understand that statistics are the bedrock of solid science and a model of solid reasoning when properly understood. Of course, real life situations do not meet all the criterion that a theoretical statistician would fancy, but it doesn’t mean that one shouldn’t use statistics to guide your reasoning and compensate however you can where rigor cannot be guaranteed.

Concerning Didier Raoult, The Druid, he’s had the same kind of ambiguous feelings when it comes to mathematical models. Be it in his own domain or in climate science. Oh, I get it: models aren’t perfect, and may be flawed or even fatally flawed in various ways. Doesn’t mean you can just pretend they do not exist and mean nothing.

The same problem applies with statistics.

Once in a while, I do try to explain the Akaike criterion and stuff like that. It indeed is possible to popularise various ideas in statistics to the lay audience. But when scientists do not want them in their own domain, it’s hard to argue against them since they wield the concept of “authority” in a rather off-handed manner.

“Whenever I ask their opinion, they say on the one hand, so-and-so; but on the other hand, so-and-so, On the one hand, — but on the other hand. I would like to meet an economist with one hand!“

There’s a G. K. Chesterton novella: X is accused of shooting Y in the hand, sniper-style. X explains that Y was too fond for his own good of “On the one hand…. on the other hand” non-committal tergiversation, and needed an intervention.

Ronald Reagan said that “an economist is someone who sees something work in practice and wants to know if it will work in theory.” (The man said something clever once in his life.)
Apparently Navarro is someone who sees something that doesn’t work in practice or theory and promotes it because he wishes it was true.
Incidentally, I think I know where Trump got his idea about the pandemic’s magical ending. Years ago the fake psychic (or is that a redundancy?) Sylvia Browne made a prediction in one of her books that reads superficially like the current pandemic. Part of her prediction was “Almost more baffling than the illness itself will be the fact that it will suddenly vanish as quickly as it arrived…”. That great epidemiologist Kim Kardashian dug it up and put it on social media. We know that Kim K.sometimes has had Trump’s ear and that he pays attention to Twitter and other social media so it isn’t a stretch.
Read all about it here:

“Yeah. Well explaining statistics is a whole endeavour on its own.”

True, but that’s no excuse to do it badly or to give fundamentally wrong information (if I had a dime for every time COLLEAGUES in other department had told me they learned a p-value was the probability the null hypothesis was wrong I’d be rich).

Don’t be too hard on models — essentially none are over correct, but they can be convenient descriptions and approximations.

@ dean

The main way I explain to people that p-values do not mean what they think they mean is to make them think about the concept of “critical preference”. That’s the way I make them understand that having only a H0 hypothesis is not even sufficient. Then I explain why the explanation you criticized is wrong. If they can wrap their heads around these two big criticisms of the usage of p-values, they can start nailing down where the H0 hypothesis stands epistemologically. But, yes, it’s a long way to go before even considering discussing information geometry, the Akaike criterion, or subtleties of bayesian stats…

I recall that the first time I was exposed at uni to statistics, the way hypothesis testing was exposed was utterly unsatisfactory to my mind. I did “get it”, but I was instinctively reluctant to use it, because it was obvious people were bound to misuse or misinterpret such tests. And I haven’t been deceived over the years by the extent of that specific kind of misuse…

I’m not too hard on models. I lambast overreliance on them, and I lambast people not wishing to use them. You cannot work on time series if you do not wrap your head around the proper use of models. Which is the right place to start IMO if you want to study model selection in the most rigorous of truly non-trivial cases.

statistics are the bedrock of solid science

This statement has been bugging me for over a day, but I’m having a hard time really nailing down the best counterexample to put the error into the proper relief. Obviously, SR and GR are exact theories, although nailing down the value of the cosmological constant in the latter is a matter of experimental controversy, so that’s suboptimal.

The Schrödinger equation is of course linear and deterministic, but it’s not going to spit out the results of arbitrary experimental setups. On the other hand, statisticians are not likely to solve the measurement problem or wring out applications from the four-color theorem.

@ Narad

Then my take on the issue: bedrock of science is mostly rationality and philosophy of rationality in the largest sense. What I really meant with my statement would better be rephrased in that way: statistics are the domain where decision under uncertainty is the most thoroughly and rigorously studied. Given that scientific statements are essentially speculative in nature inasmuch as the most scientifically valid theory is the theory which among all competing speculative theories has withstood the most criticism (logical or empirical, typically), this selection process is intrinsically tied up with statistics, not only in the way statistics are applied, but more importantly in the way statistical knowledge has been built up.

In a nutshell, science is essentially theory selection, and statistics are essentially about model selection. Not much of a difference here, and quite a deep relationship.

There’s also more to science than theory selection, such as the art of building up theories, but that’s another topic if one is looking for a mathematical analog in the same way (I’d go looking into Kolmogorov complexity theory if I had to start answering this one on a theoretical level.)

Given that scientific statements are essentially speculative in nature inasmuch as the most scientifically valid theory is the theory which among all competing speculative theories has withstood the most criticism . . . .

Is the statement that brine has a lower freezing point than pure water essentially speculative?

@ Narad

“Is the statement that brine has a lower freezing point than pure water essentially speculative?”

Yes. That’s popperian orthodoxy: reality could be conspiring against you to screw all your measures, your sight, and your mind. Who knows?

All statements are speculative in nature, even logic itself. But speculative doesn’t mean backed up only by weak reasons. It only means that it holds inasmuch as it withstands all critical attempts to refute it, whether they be by logical or empirical means.

When you have more than two speculative competing theories that you haven’t fully discriminated against, you are not forced to say that one is true and that the is other is false. You’re allowed to hold them both in your head, and assert critical preferences between them depending on contexts. That’s one of the essential meanings of what being speculative in nature is.

Of course, when you have only one theory left, calling it “speculative” is abusive. But remember that newtonian gravity is not only “useful” or “a model” or whatever. Newtonian gravity is wrong. And we also know that general relativity is wrong, no matter how useful. Because of quantum mechanics. They’re not even speculative in nature any more even though one is clearly better than the other. Because both are known to be wrong. String theory is not known to be wrong to my knowledge, but it remains speculative, and when we will have built that particle accelerator the size of Uranus’ orbit, it will still remain speculative as long as it withstands experimental attempts to refute it or logical attempts to refute it internally or with respect to some other conflicting established theory.

All models are wrong. Some are useful. Indeed. Same goes for scientific theories.

The attitude claiming “theory works, therefore theory is true”, sometimes known as “scientific realism”, is bogus. Plain and simple. For many reasons including logical strength issues in arguments. Doesn’t mean a wrong theory is not useful… because it does work. At least, we can be more sure of that than of the theory itself…

OK, it’s epistemological brainfuck of minimal practical use in day to day science. But it’s one of the most solid ways to conceptualise rationality itself across the whole board of human knowledge.

reality could be conspiring against you to screw all your measures, your sight, and your mind

I guess you haven’t been around long enough to know that I reject ontology.

And we also know that general relativity is wrong, no matter how useful. Because of quantum mechanics.

GR is incompatible with QM; this does not mean that it’s “wrong” for that reason, although it is expected to break down in the very strong curvature regime.

They’re not even speculative in nature any more even though one is clearly better than the other.

Do tell.

Because both are known to be wrong.


String theory is not known to be wrong to my knowledge . . . .

String theory is not even wrong: There is basically no theory in the first place, nor any predictions.

@ Narad

“I guess you haven’t been around long enough to know that I reject ontology.”

I have no clue what you’re talking about.

“GR is incompatible with QM; this does not mean that it’s “wrong” for that reason, although it is expected to break down in the very strong curvature regime.”

Yes. It does mean that it is wrong, no matter how much you may want to dance around it. Wrong, but useful.

“Do tell.”

Newtonian mechanics and general relativity are both wrong. But you do get better results with relativity.


Again. Both are wrong. Because of the definition of the word “wrong”.

“String theory is not even wrong: There is basically no theory in the first place, nor any predictions.”

No. There is a theory. And this theory is either right or wrong, and theories have a good track record of being wrong. Predictions could be carved out for experimentations with a particle accelerator the size of Neptune’s orbit. So, no.

Told you: “scientific realism” is bogus. Doesn’t change the fact that you can do rigorous science without so-called “scientific realism”, which is quite adequate nonetheless for everyday work…

“Popper argued strongly against the latter, holding that scientific theories are abstract in nature, and can be tested only indirectly, by reference to their implications. He also held that scientific theory, and human knowledge generally, is irreducibly conjectural or hypothetical, and is generated by the creative imagination to solve problems that have arisen in specific historico-cultural settings.” — Wikipedia on Popper.

If you need other references, do tell me. See ya.

No. There is a theory. And this theory is either right or wrong, and theories have a good track record of being wrong. Predictions could be carved out for experimentations with a particle accelerator the size of Neptune’s orbit. So, no.

You appear to have put SUSY and “string theory” into a blender.

“I guess you haven’t been around long enough to know that I reject ontology.”

I have no clue what you’re talking about.

That’s odd, given that I included your mixed metaphor for context in the first place.

@ Narad

“Rejecting ontology” doesn’t mean much to me. Even George Berkeley who was rejecting a large part of reality itself wasn’t rejecting ontology as a discipline.

What does SUSY mean to you ? “Supersymmetry” ? Your acronym is not clear to me.

“Rejecting ontology” doesn’t mean much to me. Even George Berkeley who was rejecting a large part of reality itself wasn’t rejecting ontology as a discipline.

Didn’t Berkely fall back on the “Mind of G-d”? Hume got closer, but he failed to pony up the promised “principle of association of ideas.” Anyway, I might as well cut to the epistemological chase.

@ Narad

I endorse neither Berkeley’s nor Hume’s views on the topic you mentionned.

As to ANITA and supersymmetry, the paper does claim that decay patterns of cosmic rays would yield credence to the stau supersymmetry particle, as far as I’m aware.

What nailed the coffin of supersymmetry, according to you?

(And I can go on the epistemological chase for quite a long time, so it’s up to you to decide to give up or not…)

“You’re a time series guy/gal?”

No, but everyone is familiar with that quote and what he meant. My Ph.D is in an area of robust statistics, but I’ve been doing more applied work in data science and modeling recently.

Final comment since this is getting too far from Orac’s primary focus: one of the biggest benefits of the explosion of affordable computing power and storage is the ability we have to work and teach with reasonably large and realistic data sets and know that students have the ability to do the same with their own machines instead of being tied to a univesity computer lab as I was in undergrad and grad school.

That’s also a downside. There have always been cranks about science, but now they can run a canned procedure that they don’t understand and probably isn’t appropriate for the purpose and then present bogus results as legitimate.

1) Yup, Dr Fauci is an extraordinary ambassador-clinician which is why he’s lasted so long in his current role. He also epitomizes Osler’s description that the practice of medicine is an art, based on science.
2) Well, as I seem to be saying more frequently, it could be worse. At least Le Grande Orange has his minions are seeking Dr Oz instead of Mike Lindell (the MyPillow guy) for his take on Hydroxychloroquine. Both Oz and Mike seem to qualify as WH consultants during this pandemic because they both have recently paid millions in settlements for false advertising. Birds of a feather…

I strongly suspect, due to the cynicism my collection of birthdays has given me, that Fauci may be either dismissed or side-stepped fairly soon, for not falling in line with Trump’s stories. Trump’s administration has a history of eliminating expertise that makes him unhappy.

IIRC our great leader, all hail to the omniscient Orac, once proposed a contest among surgeons, physicist and economists for the award of “Most Arrogant”

I think we have a winner.

I am psychologist by training and still remember a bit of stats and experimental design so I, too, can recognize basic problems but I don’t have the skills/knowledge to evaluate a complicated medical paper. My impression always has been that economists don’t learn much if anything about experimental design at the nitty-gritty data gathering level.

Well, maybe but my impression is that if you scratch a behavioural economist you often find a cognitive/social psychologist, See Daniel Kahneman or Dan Ariely.

You should probably include engineers in that arrogance contest. Some engineers are fine people who recognize their limitations (I know a few). But engineers seem to be disproportionately represented in areas such as climate change denial, evolution denial, etc.

I have heard it said that the main difference between scientists and engineers is that scientists are trained to deal with things as they are (how does that phenomenon work?), while engineers often deal with things as they would like them to be (let’s put this bridge here, or design a widget that does X, Y, and Z). The latter attitude can work well when you are planning a highway or trying to build a better tool for some specific problem. But it’s a lot less portable than many engineers realize.

I’d say the opposite for engineers. We are trained to take what works and apply it. We are also frequently asked to perform miracles with limited and inappropriate equipment, which makes us versatile. It maybe that this life experience inclines us to think our opinions have authority in other areas of expertise. I’d say no more than any other professional though.

Then in real life engineers deal with managers and their clueless administrative assistants. Apparently managers (often former engineers) actually think unobtainium exists. Then their administrative assistants are confused that you have not done an analysis of the fully manufactured product when it is so far behind none exist, the prototype is still being fabricated! No, I cannot do a final functional analysis on a product that has pieces still being assembled all over this country. Now let me go back to see if the particular widget or fastener that goes on this product meets our specifications with this really boring lab report from somewhere in the Midwest. (stuff I need to do while we wait for the real timeline to show the manager timeline was wildly unrealistic)

@ Eric Lund

“But engineers seem to be disproportionately represented in areas such as climate change denial, evolution denial, etc.”

Got one of this type in my vincinity. Though it’s not climate change denial per se, but rather lamentation that other real world issues like water scarcity are not addressed in priority. Also a lot of tension between this kind of engineer and eco-loons that can’t get their priorities straight: In the end, it boils down to anger that such eco-loons are branding climate change as the ultimate reason to break away from capitalism and rebrand economy as needing to be rethought in a neo-marxist way.

It’s not climate change denial per se, as far as I see it, but I’m 99% sure that it would be construed that way by many.

And I’ve also witnessed this peculiar kind of people branding others as climate change deniers for awfully ridiculous reasons with an ideological software running in the back of their psyche. Fed up with people instrumentalizing science to make cheap arguments that are wholly besides the main point being discussed.

The aircraft carrier commander needs discussing.

MAJOR-GENERAL SHAFTER. SIR: In a meeting of the general and medical officers called by you at the Palace this morning we were all, as you know, unanimous in our views of what should be done with the army. To keep us here, in the opinion of every officer commanding a division or a brigade, will simply involve the destruction of thousands.

There is no possible reason for not shipping practically the entire command North at once. Yellow-fever cases are very few in the cavalry division, where I command one of the two brigades, and not one true case of yellow fever has occurred in this division, except among the men sent to the hospital at Siboney, where they have, I believe, contracted it. But in this division there have been 1,500 cases of malarial fever. Hardly a man has yet died from it, but the whole command is so weakened and shattered as to be ripe for dying like rotten sheep, when a real yellow-fever epidemic instead of a fake epidemic, like the present one, strikes us, as it is bound to do if we stay here at the height of the sickness season, August and the beginning of September.

Quarantine against malarial fever is much like quarantining against the toothache. All of us are certain that as soon as the authorities at Washington fully appreciate the condition of the army, we shall be sent home. If we are kept here it will in all human possibility mean an appalling disaster, for the surgeons here estimate that over half the army, if kept here during the sickly season, will die.

This is not only terrible from the standpoint of the individual lives lost, but it means ruin from the standpoint of military efficiency of the flower of the American army, for the great bulk of the regulars are here with you. The sick list, large though it is, exceeding four thousand, affords but a faint index of the debilitation of the army. Not ten per cent are fit for active work.

Six weeks on the North Maine coast, for instance, or elsewhere where the yellow-fever germ cannot possibly propagate, would make us all as fit as fighting-cocks, as able as we are eager to take a leading part in the great campaign against Havana in the fall, even if we are not allowed to try Porto Rico. We can be moved North, if moved at once, with absolute safety to the country, although, of course, it would have been infinitely better if we had been moved North or to Puerto Rico two weeks ago. If there were any object in keeping us here, we would face yellow fever with as much indifference as we faced bullets. But there is no object.

The four immune regiments ordered here are sufficient to garrison the city and surrounding towns, and there is absolutely nothing for us to do here, and there has not been since the city surrendered. It is impossible to move into the interior. Every shifting of camp doubles the sick rate in our present weakened condition, and, anyhow, the interior is rather worse than the coast, as I have found by actual reconnoissance.

Our present camps are as healthy as any camps at this end of the island can be. I write only because I cannot see our men, who have fought so bravely and who have endured extreme hardship and danger so uncomplainingly, go to destruction without striving so far as lies in me to avert a doom as fearful as it is unnecessary and undeserved.

Yours respectfully, THEODORE ROOSEVELT, Colonel Commanding Second Cavalry Brigade.

Signed by all the officers, the letter was delivered to Shafter and meant for delivery to the Army Headquarters in Washington.

Perhaps fearing inaction on the side of Shafter, a copy of the letter also found its way to an Associated Press correspondent – allegedly at the hands of Roosevelt — who cabled immediately to AP headquarters.

The letter was published that same day on August 4.

When the news broke stateside, President William McKinley was indignant, requesting that “every possible effort [be] made to ascertain the name of the person responsible for its publication.”

There’s a reason Captain Crozier’s crew gave him rousing applause when he disembarked. They knew he’d sacrificed his career to save them, which was his duty. He did it well.

The instant I read about that letter, I knew he’d ended his career. I think he knew when he wrote it.

I think he is a true leader, someone who backs his man, not withstanding the personal consequences.

Is it really that difficult to tell the difference between 100 and 1 — just for starters? Don’t think Navarro is employing much of his Ph.D skills at this point. Excuse me while I barf and tend to my flowers. We need to good information to help us along not goofballs with garbage in their mouth. Again thanks — .

hhmmmm any thoughts re smoking or vaping cannabis on this one may kill the viris in the air ways or lungs ??? just saying…happy bob from oz ,,cheers ..


Cannabis is an ‘immuno modulator’ {they used to tell us in screwel that it suppressed the immune system so it would give you aids after the teacher fucked you but what it really does is just calm it down a little — It is great for asthma and calming your body down into not thinking every grain of pollen is trying to kill you} so yes, it may be efficacious against the dreaded ‘cytokine storm’.

As an anecdote, I notice that Denver (one of the first places recording ‘communal spread’) is doing relatively dandy.

@ Tim

THC and CB2 agonist are immunosuppressives. Other cannaboids are quite the opposite. So avoid the wrong strand of hemp.

But I’d really dread the severe bad trip one would have to undergo with massive hits from the bong to expect to have a modicum of chance against a cytokin storm. Doesn’t seem a good idea to me…

Robert, please let your lungs have a break. Thus far in human history there’s no evidence that breathing any kind of smoke kills nay kind of virus in the airway. All it does is damage the lungs. I’m not telling you that you can’t enjoy your favorite substance, just please don’t smoke or vape. If you get COVID-19 you will need every single bit of lung capacity you could possibly have.
Stay safe, stay home, wash up and don’t smoke. Have a brownie or something.

@ JustaTech

Heard stories that for industrial era coal miners, smoking was indeed beneficial, as it was indirectly a way to expectorate worse stuff. Do not know if it is an urban legend, though…

@ robert walton

Yeah. Drop the cigs and go for hemp butter if you cannot or do not wish to go clean….

@ robert walton:

Even famed cannabis aficionado, Bill Maher, only partakes of edibles since COVID-19.
Stay safe.

Guess Navarro as part of the nobody saw it coming crowd, missed what Dr Fauci co-wrote in JAMA ( JAMA. 2020;323(8):707-708. doi:10.1001/jama.2020.0757 ) Jan 23 ( ) where the most relevant that Navarro might even understand “While the trajectory of this outbreak is impossible to predict, effective response requires prompt action from the standpoint of classic public health strategies to the timely development and implementation of effective countermeasures. The emergence of yet another outbreak of human disease caused by a pathogen from a viral family formerly thought to be relatively benign underscores the perpetual challenge of emerging infectious diseases and the importance of sustained preparedness.”

Navarro probably doesn’t read JAMA papers, but he did see it coming. There is a news report today that Navarro wrote a memo in January raising the possibility that the novel coronavirus could kill as many as half a million Americans if an epidemic broke out in the US. He may have had ulterior motives for that–wanting to shut down US-China trade is among Navarro’s crank ideas–but he did see it coming, and put it in writing.

That is in addition to the intelligence reports in early January that this had the potential to be a nasty epidemic. But as the old saying goes, intelligence reports are only useful to the intelligent.

I studied statistics at O & A level, at BSc level and post-grad – plus as a research fellow. It left me with a deep understanding; basically a deep understanding that statistics are fucking hard.
Economists that have descended into the world of politics are very unlikely to have learned even that much.

Urban Dictionary had this definition today “Hydroxy Moron – One who preaches the miracle nature of hydroxychloroquine sulfate that has nothing to do with the business degree they hold or the virus they’re trying to cure.
Donald Trump, the proud holder of a store-bought degree in business from Wharton School of Business, waded in to the COVIC-19 discussion by suggesting hydroxychloroquine sulfate might be a miracle intervention with absolutely no foundation, making him, in medical vernacular, earning the title “hydroxy moron”.

The Orange Mussolini is so desperate for salvation from his woefully incompetent response to the coronavirus pandemic that he is willing to gamble with the lives of many to look like he’s doing something. Perhaps his equally inept UK counterpart would be willing to try it out.

The state of our knowledge about whether hydroxychloroquine might be a useful treatment for COVID-19 is basically unchanged since Friday.

I’m following a blog from a society specialized in protective gear. They usually have nice wrap-up on topics related to infectious diseases or chemical hazard.
In their last post about treatments for covid19, they mention chloroquin & hydroxycloroquin, and included a nice picture about the mode of action of these two drugs on the virus.
No, not a “potential” or “supposed” mode of action. THE mode of action, namely a perturbation of the endocytosis of the virus. With Azithromycin thrown in for good measure, because of course it is.
About everybody else still don’t know for sure if there is an action, or if there is one, how it’s happening. According to Derek Lowe, even their mode of action on malaria is not known for sure.
Of course, no citation to support their claim.
I’m torn between the polite stance “I don’t know everything so of course I missed that” and “are you just wishful thinking / BS us?”.

Back in 2016, Orac’s biggest expressed concern about Trump was that his history of anti-vax-ish statements would balloon into some sort of anti-vax policy measure. But I said that should be the least of our worries because Trump is always after money and power, and anti-vax moves just didn’t offer him profit. I offered that with should, with a greed-head like Trump, heed the immortal words of Mark “Deep Throat” Felt, and always follow the money. And it turned out pharma stocks were one of the biggest sectors represented in Trump’s personal portfolio…

So, has any journalist thought to ask ‘who stands to profit from a hydroxychloroquine boom?”? Indeed, yes, at the NYT:
• Sanofi produces Plaquenil, the brand-name form of hydroxychloroquine.
• Trump’s three family trusts have investments in a Dodge & Cox mutual fund, with Sanofi as the largest holding.
• Billionaire Ken Fisher, a major Republican donor (including to Trump) is one of Sanofi’s largest shareholders.
• Commerce Secretary Wilbur Ross used to run a fund that has significant holdins in Sanofi and Mylan, which is also ramping up to produce generic hydroxychloroquine..

It turns out the Trumps’ holdings in Sanofi are small, so Trump wouldn’t be getting the big bucks from a hydroxychloroquine.rush. It’s more like some of his key cronies stand to make bank though, and they’re bending his ear. That Giuliani was cited was a big clue, because he’s a total money grubber, and always has some kind of cash motive behind whatever policy he puts forward within the wing-nut mediaverse.

I suppose Oz could be in it just out of sincere wooey belief and/or his typical fame-whoring… But I doubt it.
If not a financial tie to the makers of the pills, maybe some deal he gets for doing a bit of pro-RTT shill work?

I think Dr. Oz is in it for the ratings. Peddling false hope is good for his ratings, and therefore good for his bottom line. It’s just that simple.

If not a financial tie to the makers of the pills

Don’t forget fame.
Achieving – or maintaining – name recognition could be a motivation on its own. Every times a newspaper put your name in its headline, its free advertising for any merchandising you may have to sell. Or just to keep your usual TV rating, because your audience expects you to jump on the bandwagon. These are medical news, how could America’s doctor not talk about it?

Two weeks ago, I didn’t know anything about any infectious disease institute in Marseille, and if I walked into a bookshop, Raoult’s book on Covid19 would have been only one book among a dozen on the same or similar topics.
Not anymore.

Additionally, if I was to walk in a bookstore two weeks ago, I wouldn’t have been interested in a book on the pandemic (because escapism), but after all the noise about his treatments, if I had been swayed by his arguments, I guess now I would be interested.

Oh, and for what’s worth. Raoult does have the backing of Big Pharma, if only of Sanofi. At any rate, I doubt Sanofi is displeased with Raoult promoting a new use for two old drugs on their catalog.
Yet it’s the other side which is given the “arrogant condescending doctor” and “pharma shill” treatment. Interesting times…

You know, in the past I’d have thought it was just the ratings and the fame-boost and all of that. I’d agree that’s certainly enough motivation. But here Oz is Rudy Giuliani adjacent, and what Rudy’s Ukraine dealings have shown me is that the Trump circle never settles for enough. Maybe I should have known better: Capitalism, after all, never settles for enough. It’s all about maximizing gain, and getting eating by the tougher dog coming behind you if you don’t. And so it is with corruption now. You don’t just leverage Javelin missiles to get Ukraine to smear Joe Biden, you work a sweetheart oil lease for cronies, and various other kickbacks into the deal.

There’s no shortage of wanna-be celebrity ducktors who would love to displace Oz as America’s Quack, or at least Fox’s/Murdoch’s Quack. If he could wangle a discreet mutual back-scratch deal with Sanofi, why wouldn’t he? Or, more likely, if he can promote Right-To-Try via hydroxychloroquine, that could open doors to various perks doled out by the right-wing money machine – Koch money and other oligarchic cash, as is funding the Goldwater Institute – which is all intertwined with Fox. There are just so many income sources there that don’t, like ratings, depend on popularity with the lumpen masses.

Simple is small. These guys think bigger.

Trump’s economic philosophy comes straight from the wisdom of Willie Sutton. Asked why he robbed banks, he replied “That’s where the money is.”
He also has changed Harry Truman’s famous statement to reflect his idea of governance – “The bucks stop here”, that sign probably on the wall at Trump Tower.

In other news…

Del Bigtree ( @ High Wire Talk) cites ( NYPost) a study concerning the aforementioned drug found that doctors have prescribed it or thought it effective ( over 6000 Ss). Right. It was a POLL of international doctors. SBM by survey?

An on-line poll of members of a specific social-media platform with no information about the number of responses as a fraction of possible responses:

“The three most commonly prescribed treatments amongst COVID-19 treaters are 56% analgesics, 41% Azithromycin, and 33% Hydroxychloroquine”

The Daily Heil found the poll and puked up their own engarbaged version of it, with made-up numbers of their own. From there to the NYPost; from there to Bigboote.

As I write..

NY’s governor discusses figures that illustrate- perhaps- a flattening of the curve.
How we behave affects the numbers., he says. We have to continue.

I need to ascertain how right wing loons like Mike Adams will react to the fact that the unruly, ungodly city folk STAYED home from the fleshpots, cabarets and gambling dens of the Tristate area. He always predicts widespread civil strife, gang wars, murder and major looting escapades in large cities if anything goes wrong.
If you don’t believe me, look at photos of deserted tourist traps, boardwalks and highway overpasses.

<, look at photos of deserted tourist traps, boardwalks and highway overpasses./i>

Photoshopped. Mikey has proof.

@ John Kane:

According to Mikey**, Orac, his minions, including you, me and the rest of the sceptics are photoshopped as well.

** I believe that I was the first to ever call him that

We’re starting to see a flattening of the curve here in Washington too. The schools are closed to students for the rest of the year, the stay-at-home continues through at least May, so hopefully we’ll be able to keep the curve flattened.

Via a political blog I follow, I am picking up rumors that somebody in Texas has decided to test hydroxychloroquine as a COVID-19 treatment on patients in a nursing home. This is not even an attempt at a proper trial–there is no blinding in the test. It is also unclear whether the patients in this test gave proper consent, or are even capable of doing so–it appears that families of the patients involved were not notified.

No link because at this point I regard it as a rumor, and I hope the rumor is not true. If it is, I am sure readers of this blog need no explanation of why such a test would be fractally unethical.

I’m a regular reader of Derek Lowe’s “In the Pipeline” blog because I’m an ex-chemist and he writes well about the pharma business. But he’s done a number of pieces on COVID-19 and the drugs being tested/proposed (all very sensibly written), and the most recent one had a comments column that looked like the product of a penny stock pushers’ convention for chloroquine-something. And the reports of doctors “who have treated thousands of patients” – really, the only doctors who have treated thousands of patients, if any, are in China, or Italy or Spain or New York, and the doctors in those last three groups are surely too busy, and too wise, to be pontificating on the benefits of unproven therapies. It’d be great if something did work without undue side effects, but I’d like evidence rather than anecdote or ill-informed hype.

Indeed. A number of commenters seem to be really convinced on using [insert some drug combination] and zinc.
1 – they are the only talking about zinc, the various recent studies about CQ/HCQ don’t mention anything about Zn
2 – I strongly suspect the dozen or so of Zn proponents to be the emanation of a single-digit number of writers. Low single-digit.

Those comment threads are a case-study in incoherence and internal contradiction.

“If you were on your death-bed with lungs filling from COVID, I know you would totally accept HCQ, therefore it works. Also, HCQ must be administered at an early stage – preferably before the symptoms develop.”

“We know that HCQ works because of those trials in Marseilles and in China. But it needs to be supplemented with Zn to work (so positive results from those Zn-less trials in Marseilles and China must have been fake).

Zelenko’s frady claims are mentioned frequently. His uncertainty about how many patients he treated is not mentioned there. Nor is his shifting story on how many of his patients recovered / are on ventilators / died.

If you were on your death-bed with lungs filling from COVID, I know you would totally accept HCQ

I hate these type of questions, because I parse them as
“If you were in a dire situation, will you panic and make stupid decisions?”

Yes, I know from experience I totally will.
That doesn’t reassure me one bit about the usefulness of miracle cures.
I would prefer to ascertain before I panic that there will be some chance of me grabbing something useful.

I think I have seen an English-language version of that paper, or at least the abstract, and have been wondering why it was being ignored (by real doctors/researchers/policy makers not, the idiots)

Her Majesty The Queen addressed the nation on Sunday. In that address she mentioned science. She did not mention homeopathy, Goop, Gerson therapy or dietary supplements. It would seem that our monarch is not Woke.

But she did kindly wear that solid green suit, so delightfully suitable to applying cute and funny images over. I particularly liked the Queen in the classic “three wolf moon” shirt.

I’m impressed Charles didn’t get to shoehorn homeopathy in there somewhere. Maybe he’ll give up on it now? (Yeah right.)

I’m impressed Charles didn’t get to shoehorn homeopathy in there somewhere. Maybe he’ll give up on it now? (Yeah right.)

Oh he’s too busy nursing his covid-19 infection at Balmoral right now, that he travelled to while infected and against shelter-in-place orders, and had contact with several people when he arrived. Twit.

My favorite has her in a Stark Trek uniform on the viewscreen on the bridge with Riker and Picard talking to her.

Hi there, I recently found your blog again and I’d like to express my gratitude for all your work
I’m a teacher and therefore I don’t necessarily have the time to debunk dubious claims, that’s why I come here to read your take on things!
Recently a lot of family and friends have been posting yet Another claim of a silver bullet cure for Sars-2. This time it is the BCG-jab
Here’s one article:

That’s very interesting. I only know one person who’s had the BCG and it caused her no end of trouble with her college health system. One of the side effects of the BCG is that you test positive to the standard skin-prick TB test used in the US (because we don’t give the BCG in the US). My friend grew up on a country that does regularly give the BCG, then moved to the US for school, had a sink=prick TB test, her arm swelled up and the nurses were convinced that she had TB and insisted on chest X rays and wanted my friend to take the whole TB antibiotic course even when the chest X-ray was clear.
They’d never heard of the BCG vaccine and it took several very expensive international phone calls to get it straightened out.

Basically, widespread use of the BCG means you can’t use an antibody test to screen for TB.

An anti-malaria drug touted by President Trump as a potential “game changer” amid the coronavirus outbreak showed no benefit for patients, according to an analysis of those hospitalized in Veterans Health Administration medical centers.

The analysis found the two primary outcomes for COVID-19 patients treated with hydroxychloroquine were death and the need for mechanical ventilation.

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