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WTF happened to John Ioannidis revisited: The Carl Sagan effect

I have been critical about John Ioannidis over a number of his statements about the COVID-19 pandemic. Now he’s done it again, producing a poor-quality paper whose unwritten assumptions suggest that the Carl Sagan effect, in which scientists are penalized professionally by their peers for becoming popular science communicators, still holds considerable sway in science and medicine.

Earlier this month, I noted the publication of an article by John Ioannidis, Alangoya Tezel, and Reshma Jagsi that caught my interest in BMJ Open, the BMJ’s open-access journal. Titled, Overall and COVID-19-specific citation impact of highly visible COVID-19 media experts: bibliometric analysis. To boil the paper down to its essence, Ioannidis examined the citation impact in the scientific literature of “highly visible COVID-19 media experts” in the US, Denmark, Greece, and Switzerland and concluded that most were not highly cited overall and few had published much on COVID-19 in particular. It’s a terrible analysis for the simple reason that its premise is flawed to the point where the results are, in essence meaningless, as I will explain. However, I did see this article as a good launching off point, a “teachable moment” if you will, to discuss science communication in the age of the deadliest global pandemic in over a century. Ioannidis was once one of my scientific heroes but since COVID-19 hit has disabused me of any previous hero worship, likely forever, although, truth be told, I had intermittently been unimpressed with his takes dating back years. In any event, this paper, published in late October but only seemingly finding an audience on social media last week (which is how I became aware of it) illustrates a problem that all of us who try to communicate science and medicine to the public face.

The Carl Sagan Effect

To understand the flaw in the premise behind Ioannidis’ paper, I have to look back at a bit of history. There has long been a disconnect between those who actually do science and those who try to communicate science and medicine to the general public. The prototypical example that those of us who do science communication, either as a sideline (as I do) or professionally, is Carl Sagan. There was even a term for it: The Sagan effect, which is basically the perception that popular, famous scientists who engage in public discourse on TV and in the media—Sagan died too young just as the Internet was rising in the mid-1990s and long before social media consumed our information landscape—are not as good in science as those scientists who do not engage in science communication with the public. One example of the “Sagan effect” that is frequently discussed the failure of his nomination to the National Academy of Sciences (NAS) in 1991, despite his being backed by prominent Nobel Laureates and analyses of his academic output having been shown to compare favorably with those of some of the most productive contemporaneous NAS members.

Basically, historically, the vast majority of scientists have looked down their noses at scientists who try to engage with the public in popular media. I can cite my own personal experience over a blogging “career” that is approaching two decades. Many are the times over the years that I’ve been subjected to sarcastic little digs—and worse!—from scientists questioning why I bother. Indeed, when I first started blogging, I used a pseudonym. Obviously, I still use that very pseudonym right here (mainly because I like it), but my real name is also pretty darned easy to find right here. The reason I started out using a pseudonym without my real name being easily associated with it back then was that I was worried about how my newfound hobby would be perceived by my bosses and fellow surgeon-scientists. When I was asked to join another blog about medicine and science as one of the founding members after I had been blogging on my own for nearly three years, I jumped at the chance, largely because by then I had been “outed” so many times by antivaxxers and cranks that I had lost my fear of writing under my real name and jumped at the chance. These days, I sometimes use my pseudonym as an “intelligence test” for trolls who try to dismiss me as just an “anonymous blogger”. If they can’t find my real name here, they’re either dishonest or stupid—or both.

It’s not just scientists, either. You might recall that a few months before the pandemic, a rising star in medical oncology, Dr. Vinay Prasad, launched a broadside against physician-skeptics who analyzed and debunked pseudoscience, quackery, and bad science for public consumption, and then doubled down on it almost exactly a year ago today. His contempt for the exercise of science communication in this sphere was palpable. Basically, his idea was that if we weren’t doing what he was doing (clinical trial analysis) we were wasting our intellects. I won’t belabor his criticisms and why they were so off base, as Steven Novella and I both responded. I will also point out that much of Dr. Prasad’s criticism of science communication has been topic-specific. Ironically, he himself has built up a rather prolific public communication infrastructure of podcasts, social media, and legacy media appearances. Unfortunately, he has also devolved into spreading misinformation and accusing supporters of mask and vaccine mandates as starting us down the slippery-slope to Nazi-style fascism.

It is undoubtedly true that this dismissive attitude towards science communication has been changing over the 17(!) years that I have been blogging regularly, even more so in the last decade or so since the rise of social media platforms like Facebook, Twitter, Instagram, and, more recently, Tik Tok. Lots of scientists, particularly younger scientists, are engaging in science communication on social media, sometimes quite entertainingly, and the stigma against such activity—and, make no mistake, it has been a stigma—has been fading. However, Ioannidis demonstrates that it is not yet gone. I also can’t help but wonder if this entire exercise is a response to some of the harsh criticism he’s received for his numerous bad takes on the COVID-19 pandemic.

The Carl Sagan Effect, as a study by John Ioannidis

Ioannidis’s study is an example of the Carl Sagan effect manifested in the unwritten but obvious assumptions behind the study. In brief, Ioannidis seems to assume that if you are communicating science to the public through the media, you are not likely to be as good a scientist, with his study being, in essence, a plea for more “high-powered” scientists with lots of relevant publications and citations on COVID-19 to make themselves available to the media and for the media to recruit more such scientists to comment on COVID-19. There are…a lot of flaws. Indeed, Ioannidis’ bibliometrics study is pretty bad and seems to have an agenda behind it that readers might not be aware of if they are unaware of Ioannidis’ history since the pandemic started. Let’s circle back and see what I mean.

Ioannidis begins:

The COVID-19 pandemic has been accompanied by an unprecedented infodemic in the news and social media.1 2 Media coverage has been intensive, continuous, massive and heated and has involved a very large number of alleged experts. The involvement of knowledgeable scholars in the public discussion and dissemination of information on such a monumental crisis is clearly welcome and indispensable. However, how knowledgeable are the experts recruited by media?

Knowledge and expertise are difficult to appraise with full objectivity. Weinstein3 argued that there are two kinds of experts, those who are recognised as experts based on what they know (epistemic expertise) and those who are worthy of being called experts based on what they do (performative expertise). According to this classification, an epistemic expert is a person who is capable of providing strong justification for a range of claims in a domain, while performative expertise characterises a person who is able to perform a skill well according to the rules and virtues of a practice.3 Performative experts may not necessarily be contributors to the scientific literature themselves, but may still know their job well and have extensive practical experience. It is very difficult, however, to appraise in a standardised manner and with consistency and quantitative metrics such performative expertise. Conversely, epistemic experts are likely to be contributors to the scientific literature and their level of contribution and impact in the science of their field is a key hallmark of their expertise. What can be readily appraised in a non-subjective fashion is the publication and citation track record of scientists who appear in news media as experts. One can use objective data to quantify the citation impact of the published work of these scientists across science throughout their career, as well as the specific impact that they are having with their scientific publications about COVID-19. While publications and citations do have limitations (as all bibliometric metrics), they are objective, readily quantifiable and offer useful information about scientific impact. Here we aimed to evaluate the overall and COVID-19-specific citation impact of the most highly visible COVID-19 experts in the USA, Denmark, Greece and Switzerland. We also paid particular attention to probing the representation of women among highly visible COVID-19 experts, as it has been previously suggested that women are under-represented among COVID-19 experts in the USA.4

I found it odd that Ioannidis starts out by citing someone named B. D. Weinstein. I briefly did a double-take, thinking that he might have cited Brett Weinstein, who, as you likely know, is an evolutionary biologist who has become one of the most prolific promoters of COVID-19 misinformation, particularly in his credulous cheerleading for the repurposed anti-helminthic drug ivermectin to treat COVID-19, a drug that almost certainly does not work and whose medical literature is hopelessly contaminated with fraudulent studies. Then I figured out that this was Bruce Weinstein. (I realize I digress, but given the mental image I couldn’t help myself.) My weird brain trick about the name Weinstein aside, Ioannidis seems to be grudgingly admitting that it’s possible to be a “performative expert” with experience extensive enough to be a reliable source of information on a topic without having contributed to the scientific literature, but you can tell from what comes next that he’s not enthusiastically endorsing such expertise. So what does he do next? He quickly pivots to his analysis, which involves in essence trying to tear down media “COVID-19 experts” by showing that most of them aren’t what he would consider high-powered contributors to the scientific literature on COVID-19. Reading this introduction, I can’t help but wonder if in Ioannidis’ construct critical care and emergency room doctors on the actual front lines aren’t “expert” enough for the media to contact.

Or:

I will also point out that a handful of such doctors have been among the most prolific promoters of COVID-19 disinformation, but I also note that, by Ioannidis’ metric, an utter crank like Peter McCullough would seem very credible just by the number of COVID-19 publications he boasts of.

Another huge problem rapidly rears its ugly head in the methods section. For example, one question I immediately asked when I first read the abstract to this paper was: Why did Ioannidis choose these three countries other than the US? I can understand choosing the US if you’re based in the US (as Ioannidis is) and because it’s the biggest producer of scientific studies and media. I can understand choosing Greece, given Ioannidis’ Greek ancestry (although one wonders if Ioannidis chose Greece because he has served as a media expert appearing in interviews there). But why Denmark and Switzerland? Why not the UK, France, China, Japan, Australia, or other countries like that? The whole set of methodology seems…odd, particularly the lack of description of the definition of “visible” as applied to media scientists and the acceptance of seemingly any old definition from the sources tapped:

We examined bibliometric indicators of top media experts in the USA, Switzerland, Greece and Denmark. These are countries for which we could identify pre-existing lists of experts who had prominent visibility in media. These lists are typically not published in the peer-reviewed scientific literature (with the exception of the US list that was previously generated and published by members of our team),4 but in media news items in different countries, thus defying the possibility for efficient systematic searches. We therefore asked our colleagues at the Meta-Research Innovation Center at Stanford (and affiliated colleagues who come from different countries if they were aware of any such publicised lists. We accepted these lists regardless of how visibility had been defined in these surveys.

For the USA, we examined the scientific citation impact of all scientists who had appeared between 18 May and 19 June 2020 during prime-time programming on three popular American cable news networks: Fox News Network, CNN and MSNBC. Details on the data collection and selection for the US list and features of the sample have been previously described.4 Of the 220 people who appeared during these programmes, 76 were scientists (47 physicians and 29 PhDs).

For European countries, searches for visible experts were made by local organisations in each country and they pertain to national media visibility. For Denmark, we found a news article that listed the 50 experts who had the highest number of appearances in media during 2020 (television, radio, newspapers).5 For Greece, we found a news article that listed the 12 COVID-19 experts who had the highest television exposure based on measured time of television appearances.6 For Switzerland, the Swiss Media Database (SMD) captures appearances in media in Switzerland. We could find information from a news article7 on the two most commonly appearing names of COVID-19 experts in SMD between mid-January and June 2020.

Also odd are the very specific time periods examined, all early in the pandemic. For instance, for the US, why did Ioannidis choose to look at a one-month period early in the pandemic? Also odd was the choice of the “top 2%” cutoff when examining whether scientists were at the top of their fields, but then I realized that Ioannidis was just mining a database he had already created. I’m with Carl Bergstrom here, when he noted:

It is indeed as stunningly lazy exercise in bibliometrics, given the small sample size and the self-referential repurposing of a database that Ioannidis’s group created for a different reason before the pandemic. Before I realized that, I was asking as I read: Why not top 5%? Or top 10%? Or even top 25%? Ioannidis’ handwaving justification in the discussion just betrays the laziness that Dr. Bergstrom noted:

First, we should acknowledge that citation metrics are far from being perfect measures of epistemic expertise. Moreover, we focused on using already existing data on the 2% top-cited scientists across each scientific discipline, and we could not examine whether scientists who were not in the top 2% of these pre-existing lists might be in the top 3% or in the bottom 5% of citation impact. Obviously, many scientists may still have considerable epistemic expertise even if they are not strictly in the top 2% of citation indicators.

Could not? No, Ioannidis chose not to go beyond his database, because looking at a larger sample would have required additional work beyond just mining an existing database created by his own research group. Lazy indeed.

There’s also another issue other than the misguided assumption that somehow being in the top 2% of researchers based on publications in the peer-reviewed literature and citations of one’s publications correlates with effective science communication, knowledge of public policy, and practical experience. Ioannidis’ analysis is very, very simplistic with respect to COVID-19 expertise, breaking publication records down to “COVID-19-related” and everything else. However, a molecular virologist working on the mechanisms of SARS-CoV-2 infection would not be a good choice to comment on mask or vaccine mandates, just as a public health expert would not be a good choice to comment on the finer points of the immune response to the disease or to explain, for instance, why the spike protein made by mRNA-based COVID-19 vaccines is not “deadly” and does not shed, as antivaxxers frequently claim. The list goes on.

Moving on, let’s look at Ioannidis’ findings:

We assessed 76 COVID-19 experts who were highly visible in US prime-time cable news, and 50, 12 and 2 highly visible experts in media in Denmark, Greece and Switzerland, respectively. Of those, 23/76, 10/50, 2/12 and 0/2 were among the top 2% of overall citation impact among scientists in the same discipline worldwide. Moreover, 37/76, 15/50, 7/12 and 2/2 had published anything on COVID-19 that was indexed in Scopus as of 30 August 2021. Only 18/76, 6/50, 2/12 and 0/2 of the highly visible COVID-19 media experts were women. 55 scientists in the USA, 5 in Denmark, 64 in Greece and 56 in Switzerland had a higher citation impact for their COVID-19 work than any of the evaluated highly visible media COVID-19 experts in the respective country; 10/55, 2/5, 22/64 and 14/56 of them were women.

I will right here, right now, point out the one useful observation in Ioannidis’ paper, namely the paucity of scientists who are women and also prominent in the media. That’s the single useful piece of information he has provided here, and he’s right that the media and scientists need to do something to diversify their pool of experts. The rest? Not so much. He is also correct to note that it is likely that racial minorities are likely to have been underrepresented, although I have a hard time believing his claim that he “could not assess the racial background of media experts”. Seriously? Has Ioannidis never heard of Google? Many of these experts likely have Wikipedia entries, and, if they don’t, by his very design, we know that they have appeared in media reports on multiple occasions. He could have had his minions just look up those media reports and see if they could glean the racial background of these scientists! Certainly, it might not have been possible in some cases, but in most it likely would have. Bergstrome is correct. This analysis is lazy.

Here’s the funny part. Ioannidis seems to recognize the problem at the heart of his analysis:

The best or the most cited scientists should not necessarily be the ones who appear the most frequently in media. Some of the experts whom we analysed have accumulated a track record of massive media engagements that require an enormous commitment of time and psyche. Many highly competitive, excellent scientists would find it difficult or even impossible to pursue their scholarly work and have an intense media presence at the same time. Moreover, especially for COVID-19, polarisation, politics and an environment of conspiracy, mistrust, and public unrest and rage may have disincentivised many leading scientists from engaging with media. Women and minorities may feel even more disincentivised in this environment.

Nevertheless, communication with the wider public is an important mission of science, medicine and public health. Information on COVID-19 in media has been shown to be of questionable quality.1 2 Its quantity is clearly immense. The vast majority is produced and disseminated by people without any scientific training and with little or no self-reflection on their inadequacy to judge complex and rapidly evolving scientific concepts. It may be impossible to diminish the bulk of information, but at a minimum its quality should be improved. Engaging qualified experts may be critical in this regard.

While Ioannidis is correct to note that political polarization, conspiracy theories, and harsh rhetoric have likely disincentivized some scientists from engaging with the media and that such engagement can take a massive commitment of time, effort, and psyche that could detract from the time that they can do science (just ask Dr. Peter Hotez, if you don’t believe me), I couldn’t help but wonder: Why, then, is he seemingly arguing that more scientists with high publication citation metrics should engage with the media and implying that the situation now is so bad because so many of the scientists who do media appearances aren’t in the top 2% measured by citation metrics? It makes no sense. I would also argue that some of what he found was actually quite reassuring. 23/76 media experts in the US during that one-month time period were in the top 2% of their fields? That’s over 30%, which I’d characterize as awesome! Ten out of 50 in Denmark? That’s pretty darned impressive, too! Two of twelve in Greece? I’d say that’s fairly impressive, as well. In all of those countries, a highly disproportionate percentage of scientists engaging with the media who were, by Ioannidis’ metrics, in the top 2% of their fields!

The assumption at the heart of this paper, namely that a high rank in terms of scientific publications and citation scores should correlate with more effective public communication is entirely off-base, as is the very simplistic breakdown of expertise into “COVID-19” compared to everything else. It also blew up multiple irony meters to see Ioannidis urge science communicators to engage “qualified experts” to improve the quality of science communication, when he seems not to have done so on so many occasions.

I hesitated to suggest this, but upon reflection decided that I had to. There appears to be another subtext here, one that is suggested by Ioannidis’ competing interest statement at the end:

JPI has given some COVID-19 media interviews (a hundredfold less compared with some of the listed experts) that have resulted in smearing, hate emails, threats, censoring, hostile behaviour, harassment and a life-threatening experience for a family member. He is among the top-cited scientists in both the overall and COVID-19-specific citation databases used in the presented analyses. In his Stanford web page, he admits that despite being ‘among the 10 scientists worldwide who are currently the most commonly cited; when contrasted against my vast ignorance, these values offer excellent proof that citation metrics can be horribly unreliable’. RJ is also listed among the top-cited scientists in the overall citation database.

Let me just preface my comments here by saying quite unequivocally that having experienced harassment, death threats, and the like myself, I will always say that this is not acceptable, no matter how much I might disagree with the person experiencing them, period. That being said, I have to address part of his statement not relating to threats of violence, noting how Ioannidis has strategically placed it in a list of that includes hate email, threats, harassment, and the like. No one—and I mean no one—is “censoring” Ioannidis. No one. Harsh criticism of bad takes is not“censorship”. After all, he is one of the most famous, most published and widely cited scientists in the world (if not the most), and media outlets are likely clamoring for him to give interviews, even as Scientific American published a defense of him against the “overreaction” to his work and predictions. Early in the pandemic, he had the ear of the Trump administration and lobbied to get it to listen to his ideas on the pandemic:

His self-deprecating self-characterization aside, notice how Ioannidis makes damned sure that you know that he is in the top 2% and included in the analysis. In context, that self-deprecation comes across as a front for an assertion of his authority on COVID-19.

A hidden agenda?

Dr. Ioannidis has clearly been very much stung by the harsh criticism of his statements made to the media during the pandemic, and, make no mistake, he has laid down some doozies, beginning very early in the pandemic with his infamous lowball estimate for deaths from COVID-19 that he said could be “buried within the noise of the estimate of deaths from ‘influenza-like illness’” or how “at most we might have casually noted that flu this season seems to be a bit worse than average”. 

Those of us who have been discussing COVID-19, vaccines, and the disinformation being spread about them have said time and time again, there’s no shame in making such an off-base estimate if you acknowledge your error and correct it as new information comes in. Ioannidis has been remarkably resistant to that. Worse, Ioannidis lashed out in an article in a peer-reviewed journal that for which he had recently served as editor at a graduate student who had had the temerity to publish results that conflicted with Ioannidis’ results and for having criticized Ioannidis on social media. It was the most egregious example of “punching down” that I had seen in a long time. Then there was Ioannidis’ repeated credulous repetitions of conspiracy theories, such as the one based on a misinterpretation of how death certificates are filled out claiming that people die “with COVID-19” far more often than they die “of COVID-19”:

Worse, he repeated as fact a claim from early in the pandemic that doctors were killing people by being too fast to intubate them. It was, in essence, a conspiracy theory. Let’s just put it this way. When a scientist as famous as John Ioannidis starts repeating misinformation like this, people are going to believe it, and he’s going to face harsh criticism that is much deserved (and not “censorship”).

The Sagan Effect still exists

In the quarter century since Carl Sagan’s untimely passing, a great deal of progress has been made in terms of erasing the stigma that exists against scientists who engage with the public to communicate about science and its findings. However, the unspoken assumption behind Ioannidis’ publication tells us that there’s still a long way to go. The problem appears to be an attitude that science communication is something that’s so easy and trivial that anyone can do it.

I can attest to the observation that the skills needed for science communication aren’t trivial. I didn’t do a formal training program and picked the skill up as I went along, and I’m always aware of that and my shortcomings. (Sometimes, I cringe when I read some of my old writing from early in my blogging “career”.) There’s a catchphrase from the second Dirty Harry movie Magnum Force in which Dirty Harry observes, “A man’s got to know his limitations.” I know mine. I’m very good at blogging and Twitter, pretty decent at public speaking and podcast/radio appearances, and not so great at TV or anything involving video. (I really need to work to get better at that.) What I’m saying is that not only is science communication as set of skills that most scientists can learn but are not trivial to master, but that there are subsets of science communication for different media. I’d have to say that Ioannidis really either hasn’t heard, has ignored, or doesn’t care about this saying about knowing one’s limitations.

I haven’t even gotten into the other mistaken assumptions behind Ioannidis’ analysis:

In the end, as much as those of us who devote time to science communication would like to think otherwise, the Sagan effect still exists. True, it’s not nearly as harsh as it was 30 years ago, but it’s still there, and papers like this one by Ioannidis are evidence of that. The ironic and depressing thing is that the “antiscience” communicators, such as Dr. Mehmet Oz, COVID-19 contrarians, and antivaxxers like Del Bigtree, are often very effective communicators, and we really need more skilled science communicators if we’re to have a chance of countering their disinformation. Once again, Ioannidis isn’t helping.

Worse, there is an ironic aspect to this whole affair:

Sadly, Ioannidis has indeed come full circle. He first became famous because of his paper about how most scientific findings turn out to be wrong, and now he’s contributing to the very problem that he identified.

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]

34 replies on “WTF happened to John Ioannidis revisited: The Carl Sagan effect”

” The Sagan effect, which is basically the perception that popular, famous scientists who engage in public discourse on TV and in the media are not as good in science as those scientists who do not engage in science communication with the public.”

Interesting, never heard of this. Seems like Feynman single-handedly refutes the basis for it; compared to science documentaries or even Sagan’s Cosmos, I’m amazed at how interesting just watching that guy sitting in a chair talking about science is.

I would bet that at the height of his recognition, very few people knew who Feynman was. As opposed to Sagan, who at his height was very well known.

The ironic and depressing thing is that the “antiscience” communicators, such as Dr. Mehmet Oz, COVID-19 contrarians, and antivaxxers like Del Bigtree, are often very effective communicators

It’s pretty clear where the bulk of their energy goes. They don’t have to put any energy into being truly correct, so they can devote all their effort to communicating as they see fit. It’s like the abstract equivalent of a gish gallop; lacking any editorial constraint on their productivity, they are permitted to exercise that full degree of productivity. How much easier it would be to polish what you want to say if you don’t have to be fully copacetic with something you may not understand.

foolish physicist writes,

“They don’t have to put any energy into being truly correct, so they can devote all their effort to communicating as they see fit.”

MJD says,

A truthful description of…….creativity, foolish physicist.

I for one am grateful to the vaccine hesitant voice in that it creates a problem to be solved.

For example, when a unvaccinated “healthy” individual presents a cytokine storm during infection and dies, the solution is to diminish cytokine storm development. Hint: A robust and active adaptive immune system supports innate immunity during acute infection to dampen the severity of a cytokine storm.

How do we effectively accomplish cytokine storm interference? Well, that’s a vaccine hesitant issue to be solved.

First, I haven’t much to say here. It’s pretty clear to me that what you, in particular, get out of these conversations has almost nothing to do with what’s actually said, which makes the conversation a non-starter to me.

Second, I said nothing at all that is a good description of creativity. Engaging in the act of creation is the heart of honest creativity. You can engage in the expenditure of energy without creating anything at all. What I said was more about economy; a person forced to obey constraints has to expend more energy abiding those constraints than someone who recognizes no constraints. Everyone has finite time to engage with the world, and how you spend your time can meaningfully alter the scope of what you might accomplish in one fashion or another; people who abide constraints must spend time and effort coping with the constraint in addition to performing the ultimate task they are trying to accomplish, but they are not less creative for the choice to do so. In many cases, such people get a greater payout for the use of their time and effort since working within the constraint is often solving a meaningful problem. Scientists speaking to the media carry a huge amount of baggage with them since they must not merely make what they’re saying palpable to an audience, but also true to the underlying science. Both tasks require time and effort independently and tackling both meaningfully limits the scope of what can be accomplished in either one discretely. Since Dr. Oz doesn’t worry about the second task, he can devote all of his energy to the first.

Third, trying to solve a problem for which an adequate solution already exists is the height of stupidity, especially when you risk dying in the act. Why waste the energy when you could be off doing anything else more meaningful, like tackling a problem for which no solution yet exists?

I have nothing further to add; like I said, I get nothing out of these conversations because I already know they go literally nowhere.

foolish physicist writes,

“It’s pretty clear to me that what you, in particular, get out of these conversations has almost nothing to do with what’s actually said, which makes the conversation a non-starter to me.”

MJD says,

@ Orac,

Release me from auto-moderation in that 5-years is long enough. In the spirit of respectful insolence, please consider adding a “dislike” option at the end of each comment.

The “Stat” link in your article has him estimating 10,000 people would die, total, from the pandemic in the USA. That’s about the weekly total now. I don’t expect to see a public apology from Mr. Ioannidis for being that wrong.

So we have been doing it wrong for 2 years?

“Cloth masks are little more than facial decorations.”

news.yahoo.com/expert-warns-cloth-masks-useless-215341566.html

Actuslly says that for omicron variant, triple masks may be needed. Do you have problems with reading comprehension ?

“… make sure that you’re vaccinated and boosted, make sure that you’re wearing a mask, even though it’s outdoors, if there are lots of people packed around you, wear a three-ply surgical mask,” Dr Wen said.

Let’s follow the science…. all of the science not what we cherry pick.The Atlantic can now be a anti-vaxxer newspaper.

“How did research with so many obvious flaws make its way through all the layers of internal technical review? And why was it promoted so aggressively by the agency’s director?”

The CDC’s Flawed Case for Wearing Masks in School

theatlantic.com/science/archive/2021/12/mask-guidelines-cdc-walensky/621035/

Narad

The article did quote and cite several scientist, who were critical of the science (the authors weren’t even sure of how many schools they studied or number of days the schools were in class, should be a red flag on the quality of the study.)

Aarno
Actuslly says that for omicron variant, triple masks may be needed. Do you have problems with reading comprehension ?

Do you really think you can get anybody to triple mask ? And everyone has forgotten the studies that show the virus (like all viruses) can be transmitted through the eyes via tears to the eye ducts then the nose. some studies suggest that a 3 fold increase in covid for people who don’t wear glasses.

“And cite a scientific article,not a journo.”

Yet you are ok when 90% of the post here are from ‘journo” articles, including our host?

And of course something else to complain about. We bet the farm on developing ‘vaccines’ while mostly ignoring treating the sick. Just like we have never had a vaccine for HIV, we just learned how to treat the sick. But then this is a ‘journo’ article in an anti vaxx website.

realclearinvestigations.com/articles/2021/12/21/did_dismissals_of_safe_outpatient_drugs_cause_needless_covid_deaths_dissenting_doctors_say_yes_808045.html

So what you’re saying is that those tens of thousands of folks who were in hospitals in the US weren’t “treated?”

I am in awe of the headline “Dissenting Doctors Say Yes”. A lazier headline writer might have said “Vast Majority of Doctors Say No.” after asking “Did Dismissals of Safe Outpatient Drugs Cause Needless Covid Deaths?” but not the RealClear Media Group!

I can’t find anything referring to wearing three masks. Did you mean a triple ply surgical mask? I buy those in a box of 100 for 15 bucks.

So, you’d rather get sick enough to need treatment, maybe in a hospital,than avoid being sick in the first place?

We don’t have a vaccine for HIV, but it’s not for lack of trying. We do have vaccines for diseases including measles, chicken pox, whooping cough, polio, some kinds of pneumonia, and some cancers. If someone gets sick anyway, because the vaccines aren’t magic-wand perfect, or because they weren’t vaccinated, doctors treat them.

Agreed, Vicki. It’s just so exhausting and disheartening when people who don’t have the slightest bit of experience or expertise in vaccine development use the lack of an effective HIV as a bludgeon against vaccines in general.

Like, yo, if an HIV vaccine was easy we would have one already. Do any of these people like Tony ever think that maybe making a vaccine against a virus that attacks the immune system might be a really hard thing to do?

Just … ugh.

“Mostly ignored treating the sick”

What have I been doing for the last two years? Has it all been a dream? I just don’t know anymore.

Sarcasm aside: What a profoundly STUPID statement. It’s a real comfort to those of us on the front lines to know this kind of thinking goes on.

Manufacturers can easily make a mask three times as thick as current,if one is needed
I do not generally post journos. You could cite the original scientific article, journos often leave out some important facts.
HIV vaccine could be preferable, but for vaccines, HIV present a bad case of circulus vitiosus. It lives in a T cells, and activation of T cells activates infection. Vaccines activates T cells …
There are drugs for COVID 19, both approved and under development. It is not just bet on vaccine,

Paul when you replied to Tony
“I can’t find anything referring to wearing three masks.”

“Actuslly says that for omicron variant, triple masks may be needed. Do you have problems with reading comprehension ?”
that was Aarno that claimed we would need to TRIPLE MASKS.

And if you are buying 100 masks for 15 bucks, you are getting what you paid for.
These masks only have to work to a 1 micron size, a Covid virus is about 0.1 micron and cost a whole lot more than you 15 cent mask and they actually work.

edcmag.com/best-asbestos-respirators/

Vicki
“We do have vaccines for diseases including measles, chicken pox, whooping cough, polio, some kinds of pneumonia, and some cancers.”

Name one of those real vaccines that we needed 4 boosters in less than a year. The new omicron virus is a sickness of the vaccinated (around 60-80 percent) of the people who get it are already vaccinated. Need proof, just look at the NFL, 150 players on Covid list, all were vaccinated, NBA 90 players, all vaccinated.

As to you and JT, an HIV vaccine has not been found, not because it is hard but because, just like covid it has so many variants, but you probably already knew that but were just being disingenuous.

Medical Yeti

sorry for your situation but If the public health officials had been forth coming and allow exploratory treatments and not politicized the treatments you might have been in a better position, as we are now worse off then before the introduction of a vaccine(s). As we became too dependent on a vaccine(s) to be the cure all to end all.

“Name one of those real vaccines that we needed 4 boosters in less than a year.”

Actually, one booster.

It’s astonishing to see the level of whining and cant from people about Covid vaccines, considering how fortunate we are to have any such vaccines that are safe and protective against serious illness and death, developed in so short a time.

Dr Bacon

You are correct (i was wrong) 2 shots and now 2 boosters (Israel has started booster number 2 or 4th shot)

I never took you for a Trump supporter, as it was his ‘Warp Speed” project that got the vaccines.

And when mandates were first announced we were told that if we got the vaccine we wouldn’t get Covid, the bar has been lowered to now you won’t get as sick. The issue is that we have had so much conflicting information by health agencies around the world and not one of those people is/was willing to say ‘at this point we don’t know”. and the politicization of the virus did not help. When a part of the political spectrum said they won’t take the “Trump Vaccine” for political advantage and now want to punish those who are vaccine hesitant.

Omicron: vaccine resistant.

nypost.com/2021/12/16/columbia-university-finds-omicron-vaccine-resistance/

and Most Omicron cases hit fully vaccinated

reuters.com/world/us/most-reported-us-omicron-cases-have-hit-fully-vaccinated-cdc-2021-12-10/

So what happened to natural immunity? I’ve had chicken pox, measles, mumps, so given the science of 2021, which claims I really need to get vaccinated against these or my natural immunity won’t work? And I have to get a shot to protect you from getting the virus, even if you’ve had the shot, tells the world the vaccine isn’t really very good. Its ironic what we will do in the name of science, in New York they shut down the gyms because you know the virus but they keep the fast food places open, when they know, one of the leading commodities of Covid deaths is obesity.

Most Omicron cases hit fully vaccinated

reuters.com/world/us/most-reported-us-omicron-cases-have-hit-fully-vaccinated-cdc-2021-12-10/

N = 43.

Problem with HIV vaccine is that HIV infects T cells. T cell activation itself activates infection. There is of course a flu vaccine, even though flu virus mutated even faster.
It is not the virus, it is a droplet containing viruses. So you must check the droplet size,
No one told you that if you get vaccine, you do not get disease. It is your own imagination. Clinical trials reported efficiency of 95%, which follow up studies confirmed.
Nobody has prevented Kory from pushing ivermectin. It is not politics, it is, for starter,lots of fraudulent trials. Have you not noticed that senetor Johnson pushes ivermectin heavily. If this is not politics,what else it is,.

Aarno

“No one told you that if you get vaccine, you do not get disease.”

Some guy named JOE did

Biden also said: “You’re not going to get COVID if you have these vaccinations.”
CNN town hall Cincinnati Ohio 21 July 2021

As to effectiveness the CDC shows the vaccines drop to below 75% after 6 months. that is why a 3rd or 4th booster is needed. And the hospitalization rate also climbs as the vaccines wears off.

“VE against infection: Data from NY State, May–August 2021”

cdc.gov/vaccines/acip/meetings/downloads/slides-2021-09-22/04-COVID-Link-Gelles-508.pdf

And No the vaccince and booster is only 33% effective against Omicron and with in 10 weeks is not effective at all. (That is why the drug companies are having to reformulate the next round of boosters).

nytimes.com/2021/12/23/health/booster-protection-omicron.html

Omicron-specific variant vaccine will be in clinical trials early 2022
cnbc.com/2021/12/20/moderna-says-booster-of-its-covid-vaccine-appears-to-protect-against-omicron.html

Anyway, what’s this about 4 COVID shots? Where I live, it’s three, two and a booster.

As for the normal vaccines that need “4 boosters in less than a year”, the DPT schedule in Australia comes close: it’s 4 shots within 16 months (the first 3 shots are within in 4 months), and then boosters at 4 years and 12 years.

https://www.health.gov.au/health-topics/immunisation/immunisation-throughout-life/national-immunisation-program-schedule

Where does this meme come from that standard childhood vaccine schedules don’t have multiple shots for a good number of diseases being vaccinated against?

pri
“As for the normal vaccines that need “4 boosters in less than a year”, the DPT schedule in Australia comes close: it’s 4 shots within 16 months (the first 3 shots are within in 4 months), and then boosters at 4 years and 12 years.”

Well I think most posters here are past the childhood stage of immunizations and only get a booster every 10 years and if you get the DPT (Tdap) your likely hood of getting those viruses/bacteria is zero or close to it. If you get 2 covid shots and 2 boosters (like Israel is now doing) your chances of getting Covid is pretty good (as I pointed out the Omicron can bypass the current vaccines) and they are working on a 5th booster that has a new twist.

nypost.com/2021/12/22/us-army-developing-vaccine-to-treat-all-covid-variants/

Actually,boosters work against omicron variant.
It is nice that cavalry is coming to help. Would you accept their vaccine ?

I’m also a little surprised they’re limiting publications to covid-19 related, too. Someone with deep expertise in other coronaviruses, infectious diseases epidemiology, and other relevant fields seems to me well qualified to speak even if they hadn’t published much on covid19 itself. Was there a reason to focus publication on COVID-19? I can easily see a long-time coronavirus scientist focusing on communication during the pandemic.

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