About a month ago, I wrote about how COVID-19 minimizers, deniers, cranks, antivaxxers, and grifters had been ramping up their demands for “debates” about COVID-19. Of course, I’ve long been pointing out how a favorite tactic of such cranks is to challenge a scientist or science advocate to a “live public debate” about the topic in question, whether it be the claim that vaccines cause autism (they don’t), whether HIV causes AIDS (it does), regarding “integrative medicine” or “complementary and alternative medicine” (CAM), or antivaxxers trying to trap me. Longtime readers know why quacks, cranks, pseudoscience-promoters, and conspiracy theorists almost always have a near-insurmountable advantage in these debates—”Gish gallop” anyone? —but, as I explain every time, there are other reasons why science deniers gravitate towards this particular tactic. Sometimes the motivations are dishonest, but more often they are not, being based instead on the false idea that such “debates” are a fair and democratic method to settle a question, whether there is a real scientific debate or not. (Almost always, there is not.)
At the time that I last wrote about “debates,” I thought that I wouldn’t have to bother writing about the topic of what I like to call “debate me, bro,” but, wow. I was mistaken! The reason is that COVID-19 cranks have been ratcheting up the demand for “debates” with scientists to 11 and taking that demand into ridiculous territory that even I can’t recall having seen before. This just goes to show that, while there might be nothing new under the sun and everything old is new again in the age of the COVID-19 pandemic, that doesn’t mean that the pandemic has had no effect. Its effect, however, appears to have been to crank up the crazy to 11 with all of the older denialist tactics. I suspect that there’s another reason why these calls for “debate” from science denialists are becoming more ubiquitous than I can remember their ever having been before, specifically as a result of increasing calls from professionals (e.g., No License for Disinformation) and attempts to penalize the unprofessional behavior of physicians who practice COVID-19 quackery and spread misinformation about the pandemic, for example, their recent appearance on ABC News:
Admittedly, some of these calls are just self-promotion of the sort used by science denialists as long as I can remember. For example, one recent example comes from a longtime topic of this blog, past producer of segments for The Doctors turned antivaxxer, Del Bigtree, who was demanding a “debate” hosted by Joe Rogan:
There’s one thing that I note here. Del Bigtree obviously really, really, really wants to get on Joe Rogan’s podcast, because, of course he does. (What crank wouldn’t, given Rogan’s millions of viewers?) His obsequious praise of Rogan reaches goes from zero to nauseating in a matter of five seconds.
More consistent with my suspicions, however, earlier this week Steve Kirsch (who was featured prominently in my more recent post about “debate me bros“) published a post on his Substack with the hilarious title, COVID-19 misinformation is a public health crisis but nobody is willing to stop it by debating us. Before I quote from this post, let me just stop for a moment to ask: How would scientists “debating” Kirsch’s motley crew of COVID-19 minimizers, quacks, cranks, antivaxxers, antimaskers, and grifters “stop” COVID-19 misinformation? No, seriously. My first thought reading the headline was: Delusions of grandeur, much, Steve? Then I read the tagline to his post: The California legislature has officially declared COVID-19 misinformation a public health CRISIS, yet the head of California’s HHS will do nothing to stop it. Neither will anyone else. And there you go. There’s the real reason, which will become apparent soon if you haven’t gotten it from the headline and the tagline:
It’s so easy to stop COVID-19 misinformation. Just debate the top misinformation spreaders. Problem solved. It will be obvious which side is the purveyor of false information.
Fact check this: No fact checker organization will debate us
I told PolitiFact that if they really wanted to stop misinformation, all they had to do was debate us. The PolitiFact Editor in Chief, Angie Holan, stopped replying to my emails at that point.
Fact check this: None of the public health officials will debate us
I don’t know of a single public health official who will debate our team. There are over 3,000 public health officials and they will not lift a finger to debate us and stop the misinformation. That’s irresponsible.
California officials are afraid to stop us
After I read this article in the California Globe:
The headline of the article? CA Lawmakers Propose Bill to Punish Doctors Who Speak Against COVID Treatment ‘Consensus’. When you look at it this way, Kirsch’s performative calls for “debate” serve more than just as a tactic to try to trap unwary experts into a rigged pseudodebate in which they would be overwhelmed by Gish galloping, appeals to emotion, and a veritable tsunami of misinformation, misrepresented and misinterpreted studies, and cherry picked data. It serves as a framing mechanism to portray himself (and, of course, all the “brave mavericks” who are supposedly “bucking” the COVID-19 “consensus”) as fearless and willing to face anyone, any time, on the intellectual field of battle, as compared to the public health science establishment, who are portrayed as cowardly and trying to “censor” these brave mavericks through law because they can’t win otherwise.
Unsurprisingly, the article referenced by Kirsch comes from a conspiracy theory and misinformation publication and echoes the crank narrative about any attempt to discipline doctors who spread misinformation:
Even as more off-label drug uses are discovered, Orwellian California lawmakers are introducing legislation to silence physicians who speak out on issues directly impacting their patients’ well-being, as well as the treatment of the coronavirus.
Last week, Assembly Bill 2098 was introduced by Assemblyman Evan Low (D-Campbell) to punish physicians and surgeons for “unprofessional conduct” for advocating for the potential benefits of early treatment with off-label drugs, or those who dare to ask questions about COVID vaccine safety.
This is quite the false equivalency here. Certainly there are a growing number of “off-label” uses being found for various drugs, and far be it from me to condemn the repurposing of old drugs for new indications. (After all, one of my main projects over the last 15 years or so has been to repurpose a drug for neurological conditions to be used to treat breast cancer.) However, the implication that these cranks try to make from the growing appreciation for how a number of old drugs can be repurposed gives away the real game:
Many drugs have other uses: Could common blood pressure medications help curb pancreatic cancer? It appears so. “New research suggests that commonly prescribed high blood pressure drugs may boost survival in patients,” MedicalXpress.com reports.
Botox injections are associated with the treatment of facial wrinkles. However Botox is used for many other conditions, including spasticity, eye twitch, neck contracture, migraines, and overactive bladder, and for the treatment of severe underarm sweating.
Most people think multi-purpose drug use is amazingly good news and cost-effective.
But as we saw during the two years of the COVID pandemic, off-label drugs that physicians across the country wanted to use for early therapeutic treatment of the coronavirus were disparaged, banned and even destroyed.
Let me just point out something about the example cited in the article, namely the observation that ACE inhibitors and ARB inhibitors, which are normally used as blood pressure medications, can improve survival in pancreatic cancer. Naturally, I went to the study itself. The first thing I noticed about it is that it was not a randomized, double-blind, placebo-controlled trial, but rather a retrospective cohort study that mined an administrative health records database. That alone makes it not particularly informative, given the potential for confounding that even careful controls probably didn’t eliminate. Worse, though, the decreases in the risk of dying in a given time period weren’t that impressive (on the order of 13-20%, but, tellingly, that benefit disappeared completely after three years. While this study might provide a rationale to see if these drugs can be repurposed to treat pancreatic cancer, more likely this study suggests some sort of confounding effect not detected in the analysis. It’s an intriguing study, but far from a slam dunk. At best, it’s preliminary.
You know where this is going, of course:
In Spring of 2020, The Federal Drug Administration and Federal Trade Commission, Department of Justice, and some state attorneys general launched a coordinated censorship campaign to prevents medical doctors and other healthcare providers from sharing their extensive knowledge about how to stay healthy during the pandemic using hydroxychloroquine and Ivermectin, and some natural treatments like vitamin C and D, Melatonin and Zinc.
Because, if you believe these cranks, just because repurposed ACE inhibitors might have a statistically detectable effect on pancreatic cancer mortality based on a retrospective study, then we have to take seriously all the claims by COVID-19 quacks that repurposed drugs like hydroxychloroquine and ivermectin are miracle cures for COVID-19 and prevent disease progression as well or better than vaccines.
But, no. According to cranks like Steve Kirsch and Katy Grimes (who wrote the article cited by Kirsch):
Is this the same game plan for California with Sen. Pan’s and Assemblyman Low’s SB 1018 and AB 2098? The State of California, Department of Public Health and Health and Human Services, which is trying to drag out the pandemic into a third year, is now trying to prescribe all medical care and treatments?
Just imagine a more tyrannical, ruthless and oppressive DMV the next time you seek medical care, should these bills become law.
This sort of argument is a hoary old canard beloved of quacks and antivaxxers going back as long as I can remember (and very likely to long before I ever started paying attention to these issues) that tries to portray any and all attempts at the professional regulation of physicians that would impose penalties up to and including taking away their medical licenses as tyrannical assaults on physician autonomy and medical freedom. Unfortunately, as I have noted before, it’s not just quacks, antivaxxers, and their supporters who find this framing attractive. All too many physicians who really should know better are threatened by attempts by state medical boards and professional societies to enforce professionalism by mandating penalties for doctors who use their professional status to promote misinformation, characterizing them as “cancel culture” or “censorship” rather than what they really are: quality control.
Today, Senator Dr. Richard Pan and Assemblymember Evan Low introduced Senate Bill 1018 and Assembly Bill 2098 to combat the spread of dangerous COVID-19 misinformation and protect public health. SB 1018, introduced by Senator Dr. Richard Pan, requires online platforms utilizing algorithms to publically report how product features interact with datasets used by algorithms to score or rank content, and requires disclosure of data for legitimate research purposes. AB 2098, introduced by Assemblymember Evan Low, enshrines into state law that licensed physicians and surgeons disseminating or promoting misinformation or disinformation related to COVID-19 constitutes unprofessional conduct that should result in disciplinary actions by the Medical Board of California or the Osteopathic Medical Board of California.
I’ll be honest. From the text of SB 1018, I must admit that I don’t entirely understand how this bill would do what Sen. Pan says that it will do, given that the text seems mostly to involve putting some teeth into requiring privacy policies and allowing users to request changes to personally identifiable information. (Perhaps someone more knowledgeable in the relevant topics could educate me.) My lack of understanding of this bill aside, social media algorithms that preferentially amplify misinformation, pseudoscience, and conspiracy theories have indeed been a huge problem that has greatly contributed to where we are today with respect to the dominance of misinformation in the public space, and any effort of government to rein in such misinformation is always portrayed by conspiracy theorists as “censorship,” whether it is or not—and it’s almost always not.
I’m more interested in AB 2098 anyway, because it’s exactly the sort of thing I have long been calling upon states to do, which leads me to Section 2 of the bill:
It shall constitute unprofessional conduct for a physician and surgeon to disseminate or promote misinformation or disinformation related to COVID-19, including false or misleading information regarding the nature and risks of the virus, its prevention and treatment; and the development, safety, and effectiveness of COVID-19 vaccines.
(b) The board shall consider the following factors prior to bringing a disciplinary action against a licensee under this section:
(1) Whether the licensee deviated from the applicable standard of care.
(2) Whether the licensee intended to mislead or acted with malicious intent.
(3) Whether the misinformation or disinformation was demonstrated to have resulted in an individual declining opportunities for COVID-19 prevention or treatment that was not justified by the individual’s medical history or condition.
(4) Whether the misinformation or disinformation was contradicted by contemporary scientific consensus to an extent where its dissemination constitutes gross negligence by the licensee.
I’ve been arguing for a very long time that spreading misinformation about health that can harm patients, such as quackery and antivaccine misinformation, should be offenses for which state medical boards should have the power to sanction physicians and even to take away their licenses to practice medicine. As a result, while I find Rep. Low’s bill to be a step in the right direction, I have to argue yet again that (1) doesn’t go far enough and (2) state medical boards should already have the power to sanction doctors who behave unprofessional by promoting dangerous misinformation and quackery about health without the need to pass a specific bill about COVID-19 misinformation. After all, why should it be only COVID-19 misinformation and care that deviates from the standard of care and potentially harms patients? Why should it be just COVID-19 misinformation that leads patients to forego safe and effective vaccines and therapy? After all, how often have I discussed alternative cancer cures peddled by doctors (e.g., Stanislaw Burzynski) that lured patients away from effective cancer therapies, thereby dooming them? Before the pandemic, how often did I argue that doctors who promote antivaccine misinformation and actively discourage their own patients from receiving standard-of-care recommended vaccines should lose their medical licenses? The answer: More times than I can remember.
My suspicion, though, is that increasing efforts to halt the spread of COVID-19 misinformation by physicians and its amplification by social media platforms are the primary reason why ridiculous calls for “debate” are proliferating more and more. I can’t resist quoting Steve Kirsch’s letter to Mark Ghaly, Secretary of the California Health & Human Services Agency, to show you what I mean:
In House Resolution No. 74 of the 2021–22 Regular Session, the California State Assembly declared health misinformation to be a public health crisis, and urged the State of California to commit to appropriately combating health misinformation and curbing the spread of falsehoods that threaten the health and safety of Californians.
To that end, I am requesting you and the team at HHS referenced in this article in the California Globe debate us. (“Are they referring to Gov. Gavin Newsom’s full-time team combating COVID propaganda?” Just last week Gov. Newsom admitted he already has “a team of people at HHS battling in the trenches and on social media trying to push back,” the Globe reported.”)
This is the fastest and easiest way to stop the spread of misinformation.
You can assemble any team you want to debate us.
On our end, I will deliver pretty much all of the world’s top misinformation spreaders.
For example, we believe over 100,000 people have been killed by these vaccines and we have plenty of independent data sources to support that. That would be a primary debate point.
Please let us know your response.
I have cc’d Katy Grimes who wrote the California Globe article.
Please cc her in your response.
I’ll express some amusement (and give Kirsch a little bit of credit for irony) in how Kirsch so enthusiastically embraces how he and his “debate me bro” cronies have been called the top spreaders of disinformation as a strategy to try to convince Secretary Ghaly that just “debating” them would somehow shut down disinformation, even as I laugh at how he takes it further in his Substack article:
If California Assemblyman Evan Low and California Senator Dr. Richard Pan honestly want to stop misinformation, they should simply tell Mark Ghaly and his staff to publicly challenge us to a debate. If he refuses, then Low and Pan should challenge us to a debate so we can show the world who the real misinformation spreaders are.
Why aren’t they doing that? That’s the fastest way to stop misinformation worldwide.
The answer is simple: because they know they’d lose. That’s why they create bills to censor people with different views.
He also can’t help but portray an unwillingness of any faculty member at MIT to invite him to give a talk there as evidence of this cowardice:
MIT won’t allow a COVID-19 scientific debate on campus: they don’t want students to know that there might be another side of the story.
At first, they told me I needed an MIT faculty sponsor for my talk on the MIT campus.
After I told them I have an MIT faculty member who will sponsor the talk and I wanted to know the next steps, I was told: “I would also like to remind you that MIT’s policies on campus gatherings remain in force. Those currently include mandatory masking and the requirement that all event attendees must be vaccinated and boosted against COVID-19.”
Great, so none of us qualify.
So much for allowing an open debate on the MIT campus.
I’m guessing that Kirsch was probably well aware of MIT’s requirements when he issued his challenge for a “scientific debate” and therefore knew that, even if he found a hapless faculty member to invite him, the “debate” would never happen.
Again, this strategy is nothing new. I’ve seen its like going way, way back. The idea is for the science denialist to contrast his supposed openness to “debate” with a portrayal of attempts to rein in disinformation, no matter the specifics of those attempts, as being “censorship” and cowardice. This sort of framing lets the crank claim victory no matter what the response is. Leaving aside the utter ridiculousness of the very idea that a “debate” as proposed by someone like Kirsch could shut down misinformation, if the challenge is ignored, Kirsch can claim victory by saying that “they” refuse to debate him because they are afraid. If the challenge is (foolishly) accepted, then Kirsch and his merry band of COVID-19 cranks can Gish gallop, cherry pick, misinterpret and misrepresent studies, and, yes, lie to their hearts’ content while elevating their status to appearing to be worthy of being on the same stage as real scientists and public health officials. It’s like this:
I’ll conclude by reminding my readers that these calls for “debate” are a tactic, nothing more. They are a mechanism that promotes science denial by giving the false appearance that it is a legitimate “alternative” viewpoint and elevates science deniers, while letting them spread their misinformation. Certainly, such “debates” are not a means of “ending misinformation.” Quite the contrary, all truth does not come from live public debates. In the end, I view the increasingly desperate calls for “debates” by people like Kirsch to be evidence that efforts to rein in misinformation and hold disinformation-spewing physicians accountable, such as No License for Disinformation, are having an effect.
Again, refusing to “debate” cranks is not cowardice. It’s wisdom. Holding physicians responsible for the quackery and disinformation they spread is not “censorship.” It’s quality control.