I and a number of advocates of science-based medicine have had a lot of complaints about The BMJ, which since the pandemic hit has been promoting a lot of bad takes on COVID-19 to the point of publishing outright misinformation about COVID-19 vaccines designed to portray them as far less safe and effective than science says that they actually are. Perhaps the worst examples were various recent “investigative journalism” stories in which facts were misleadingly presented to create a false narrative that regulatory oversight of COVID-19 vaccine manufacturing was hopelessly sloppy. I mean, seriously: Commissioning a deceptive story by crank disguised as investigative journalist Paul Thacker, anyone? Then defending him? Then publishing another biased “report” by Goop-defending hack Jennifer Block attacking the Vaccine Adverse Events Reporting System (VAERS) in a manner similar to how antivaxxers have long done in order to falsely suggest that it’s been vastly underestimating injuries due to COVID-19 vaccines? And don’t even get me started on how The BMJ hired an antivax-sympathetic, if not outright antivax senior editor, Peter Doshi, and continues to defend him even as he has contributed to antivax misinformation about COVID-19 vaccines, beginning only a month after they received emergency use authorization in the US. This history over the last four years is why I found a recently published preprint by John Ioannidis so…ironic.
Also, I never thought I’d ever be defending The BMJ, but unfortunately, Kasper Kepp, John Ioannidis, and their coauthors leave me little choice, at least in this one area. First, however, let’s delve into a bit of background.
The descent of John Ioannidis
Regular readers will know that at one time, long ago in the beforetime, John Ioannidis was one of my scientific heroes, going back to 2007 at least. In retrospect, I should have realized as early as 2012 that my hero-worship was misplaced. That was when Ioannidis published a relatively poorly supported argument that the NIH is so conservative that only the very “safest” projects are funded and that the “brave maverick scientists” who see “bolts out of the blue” to make great leaps in science tend not to be NIH funded. Such a view tends to be common among “brave maverick” doctors and scientists who view the slow accretion of evidence that makes up most scientific discovery as too timid and “safe.” Another indication was when he bemoaned the “hijacking” of evidence-based medicine (EBM) by industry. Basically, he took a common criticism of EBM and then added methodolatry (the worship of the randomized controlled trial as the only valid means of clinical investigation) to exaggerate the problem. At the time, I didn’t think much of these papers in terms of anything truly worrisome about Ioannidis’ takes, as they were mostly within the mainstream, just prone to a bit of EBM methodolatry and an overestimation of the general importance of “bold” brave maverick ideas in science.
Then came the pandemic, and, wow, did John Ioannidis go off the rails. Early in the pandemic Ioannidis was quick to embrace “natural herd immunity” approaches to COVID-19 that later became the basis of the Great Barrington Declaration (GBD), which called for a “let ‘er rip” approach to the pandemic to achieve “natural herd immunity” in six months by letting the young and healthy just get COVID and using “focused protection” to keep those at high risk of death and complications from COVID safe. It’s a tactic that never would have worked—and didn’t work—and was, at best, social Darwinist, if not eugenicist, at its heart. Although he was not an author—indeed, in fairness he refused to sign it, although not based on disagreeing with the GBD’s premise but because of his opposition to “signing petitions” as a means of settling “questions of scientific fact”—his call early in the pandemic for what sure sounded like a variation on the idea of “focused protection” was all over the GBD. He was also a co-author, along with GBD co-author Jay Bhattacharya of the infamous Santa Clara seroprevalence study that misleadingly claimed that over 80 times more people had been exposed to COVID-19 than previously thought (and therefore the infection fatality rate, or IFR, was way lower than was being claimed, meaning COVID was not nearly as dangerous as claimed and therefore all those public health interventions were unnecessary). Before that, he had published what is now in hindsight a ludicrous estimate in STAT that COVID-19 would likely kill 10,000 Americans. (He was off only by a factor of more than 100.) Then there was the time that Ioannidis made the vile evidence-free accusation that ICU doctors were inadvertently killing COVID patients by intubating them willy-nilly when they really didn’t need mechanical ventilation. And don’t even get me started on Ioannidis’ infamous “Kardashian index” paper, in which he smeared scientific critics and opponents of the GBD as “science Kardashians” using risibly bad methodology based on what was originally published as a satirical index to comment on scientists with more social media influence than influence in the scientific literature.
Another way of attacking your critics
This brings me to Ioannidis’ preprint, for which he is the corresponding author and someone named Kasper Kepp is the first author, entitled COVID-19 advocacy bias in the BMJ: meta-research evaluation. My first thought, upon reading the title, was: WTF is “COVID-19 advocacy bias”? I rather suspected what he meant, given his past history of advocating for “let ‘er rip”-style “natural herd immunity” approaches to the pandemic like the GBD going back to April 2020 and his later history of gratuitously sliming scientists who argued against the GBD and for more conventional public health approaches to the pandemic as, in essence, “science Kardashians” with far more prominence on Twitter than in the scientific literature. Of course, this is very amusing to me, for the same reasons that Gideon Myerowitz-Katz found it amusing:
And, sadly::
Also, David Grimes echoed my view:
It’s good to know that I wasn’t the only person who saw the hilarious irony in what Kepp and Ioannidis are doing here. It’s basically the same thing as what they did in a recent paper in which they basically tried to accuse the organizers of a Delphi consensus panel on COVID-19 of extreme “bias” because they included members who had advocated for “zero COVID” measures and “radical” claims such as that “COVID is airborne”—neither were “radical” at the time—and didn’t provide equal representation for GBD advocates. Basically, that paper was a lament that proponents of an approach to the pandemic not based in science were not included on a panel trying to come up with science-based consensus recommendations in 2022. It reminded me of naturopaths complaining about not being included on a panel coming up with consensus guidelines how to treat cancer. (Unfortunately, these days, all too often naturopaths and other quacks are included on such consensus panels.)
This preprint is basically the same attack, just aimed at The BMJ instead of a specific Delphi consensus panel. Again, given The BMJ‘s horrible record with respect to undermining trust in COVID-19 vaccines, I found Kepp and Ioannidis’ entire thesis that The BMJ is hopelessly “biased” with respect to COVID-19 to be risible in the extreme; if anything, The BMJ is too “open” to contrarian viewpoints, something that Kepp and Ioannidis ignore completely.
If you’re not GBD, you’re “zero COVID”?
One thing that becomes immediately clear is that Kepp and Ioannidis really have a bug up their butts for certain groups, particularly those advocating more aggressive public health measures for the pandemic, such as indieSAGE and Vaccines-Plus. Indeed, if you look at the methodology, Kepp and Ioannidis focus on these groups, mentioning them in the abstract:
Scopus was searched for items published until April 13, 2024 on “COVID- 19 OR SARS-CoV-2”. BMJ publication numbers and types before (2016-2019) and during (2020-2023) the pandemic were compared for a group of advocates favoring aggressive measures (leaders of both the Independent Scientific Advisory Group for Emergencies (indieSAGE) and the Vaccines-Plus initiative) and four control groups: leading members of the governmental Scientific Advisory Group for Emergencies (SAGE), UK-based key signatories of the Great Barrington Declaration (GBD) (favoring more restricted measures), highly-cited UK scientists, and UK scientists who published the highest number of COVID-19-related papers in the entire scientific literature (n=16 in each group).
The “control” groups are the dead giveaway as to what Kepp and Ioannidis are about. They basically fixed the methodology to guarantee that they would find “bias,” because most likely they knew that GBD advocates were not getting published as much in The BMJ, even if a “senior editor” as depressingly antivax as Peter Doshi and antivax cranks like Paul Thacker and Jennifer Brock were. True, Thacker and Brock didn’t publish scientific papers per se and Doshi’s statistical manipulations were published in commentaries, but if anything the BMJ‘s downplaying of COVID-19 vaccine effectiveness, conspiracy mongering about Pfizer, and bad “investigative journalism” were even more harmful to public health than any scientific papers would be likely to be. Again, Kepp and Ioannidis are basically angry that The BMJ didn’t embrace the GBD and so decided to “prove” that it was hopelessly “biased.”
Before I go on to describe the predictable findings of this preprint, who are indieSAGE and Vaccines-Plus advocates? So I looked them up, first indieSAGE. They appear to be a bunch of “radicals” too (at least to Ioannidis. For example, here is their 7-point plan for COVID-19 mitigation published in The BMJ in 2022:
- Clear and consistent messaging concerning covid risk and risk mitigation, reinforced by public statements by those in positions of authority;
- Increased efforts to promote vaccine uptake, among all age groups, and with particular emphasis on groups among whom uptake has been low, in particular ethnic minority communities. This should be coupled with a clear long term plan to address waning immunity and immune escape by new variants;
- Installing and/or upgrading ventilation/air filtration in all public buildings, with schools an urgent priority over the summer holidays;
- Provision of free lateral flow tests to enable everyone to follow existing public health guidelines;
- Financial and other support for all workers to self-isolate if infected;
- Systematic promotion of the use of FFP2/FFP3 masks in indoor public spaces and public transport when infection rates are high;
- Increased support for the equitable global provision of vaccines and anti-virals.
And what about “Vaccines-Plus”? I thought I’d go to one source, namely the “vaccines-plus” letter, which I found in The BMJ published in January 2022. A lot of what was in the letter sounds quite prescient now, for example:
Some countries view infection as a net harm and pursue strategies ranging from suppression to elimination.2 They seek to sustain low infection rates through a combination of vaccination, public health measures, and financial support measures (vaccines-plus). Other countries implemented mitigation strategies that aim to prevent health systems from being overwhelmed by building population immunity through a combination of infection and vaccination. These countries rely on a vaccines-only approach and seem willing to tolerate high levels of infection provided their healthcare systems can cope.
They even note:
While vaccination greatly reduces risks of serious illness and death, long covid remains a concern.12, 13 Disruption to education as a result of staff and student sickness, and/or repeated lockdowns due to failure to control the virus, are likely to have a lasting impact on the wellbeing and prospects of the next generation.14
That sure sounds as though the “Vaccines-Plus” advocates wanted to keep schools open as much as possible, in marked contrast to GBD attacks on public health officials claiming that they wanted to keep schools closed indefinitely, if not forever. Moreover, Vaccines-Plus suggestions were anything but radical. They included such “radical zero COVID” measures as:
- Unequivocally declare SARS-CoV-2 an airborne pathogen and stress the implications for preventing transmission.
- Promote the use of high-quality face masks for indoor gatherings and other high-transmission settings.
- Advise on effective ventilation and filtration of air.
- Set criteria for imposing or relaxing measures to reduce covid-19 spread based on levels of transmission in the community.
- Support urgent measures to achieve global vaccine equity, including vaccine sharing, suspension of vaccine patents, removal of barriers to technology transfer, and establish regional production centres to create a plentiful local supply of high-quality vaccines everywhere.
Again, these all sound quite sensible to me. Only if you advocate a GBD-like “natural herd immunity” approach to the pandemic would they seem somehow “biased,” as Kepp and Ioannidis try to do right in the introduction:
Science ideally develops conclusions from systematic evidence and balanced analysis of risks, intervention benefits and harms, and uncertainties.1,2 In contrast, advocacy groups lobby for specific policies, often in unilateral fashion not reflecting the full complexity of the issues involved. Advocacy has an important mission in raising awareness of critical needs. However, it may also be biased towards special ideological or financial interests that could sometimes harm society by unbalanced resource allocation.3,4
Leading medical and scientific journals publish many opinion, editorial, and journalistic pieces, and these could shape how science and evidence are perceived and what policies are adopted. These pieces are typically published quickly, often with little or no external review. Sometimes they may reflect overt advocacy that may increase the danger of bias and polarization of the scientific community.5 As more journals move towards publishing more opinion and advocacy, ethical guidelines are warranted.6
Far be it from me not to agree that advocacy is associated with bias! However, notice how one-sided this analysis is:
During the COVID-19 pandemic, science-based advocacy was common.7 While some argued for milder mitigation with restricted measures focused primarily on those at highest risk (e.g., the Great Barrington Declaration (GBD)8,9), others argued for mass suppression of the virus (e.g., the John Snow memorandum (JSM)10) or for elimination using aggressive lockdown measures, intense testing and contact tracing, social distancing, masking, and air monitoring and air cleaning interventions (“zeroCovid”).11,12 Understanding the presence of this advocacy in leading medical journals, given the historical importance of the issues involved, may help inform development of better guidelines for science-based advocacy in medical journals.
Notice how the GBD is described as “milder mitigation measures” when in reality the GBD advocated a “let ‘er rip” approach in pursuit of “natural herd immunity—in actual practice, no mitigation measures—and “restricted measures focused primarily on those at highest risk,” which were never really ever described in sufficient detail to implement and, as I discussed above, never would have worked and, in essence, didn’t work. In contrast, GBD opponents are described in less reasonable-sounding, more “radical” terms, such as “mass suppression of the virus,” “aggressive lockdown measures,” “intense testing,” etc. Left out is the observation that the GBD was outside the range of public health interventions generally recommended during a pandemic, while the rest were pretty standard public health interventions for an infectious disease spread by respiratory secretions. Not that that stops Kepp and Ioannidis from using such language in more detail in the Supplement:
Of the four advocacy groups favoring aggressive measures, IndieSAGE34 was formed in May 2020 to provide an independent, critical counterpart to the Scientific Advisory Group for Emergencies (SAGE), the official UK governmental COVID-19 scientific advisory taskforce. IndieSAGE advocated COVID-19 elimination, i.e., a “zeroCOVID” strategy.34 Membership in indieSAGE changed over time (Table S1) and not all members were equally active in advocacy while some members also changed views and/or left indieSAGE. Like indieSAGE, the WHN, initated in 2020 and led by Yaneer Bar-Yam and Eric Ding, also advocated for elimination (“zero- covid”) strategies.34 Vaccines-Plus published a manifesto34 in BMJ in January 2022, when zeroCOVID was clearly no longer feasible, arguing for efforts to tightly control infections using “effective find, test, trace, isolate, and support” strategies, use of respirators (e.g. N95, P2/FFP2, KF94) in all indoor settings, and aiming for “a paradigm shift to ensure all public buildings are designed, built, adapted, and utilised to maximise clean air”, while also advocating (less controversial) global vaccine equity. Advocates in these groups had substantial overlap with the key authors of JSM in Lancet.34
Of the four advocacy groups favoring restricted measures, GBD34 was initiated by one UK and two US scientists, advocated for “focused” protection, i.e. giving more freedom to younger age groups, including school children. This group has many UK scientists in the list of publicly visible key signatories. CollateralGlobal was initiated by UK scientists and emphasizes increased focus on the adverse effects of pandemic mitigation policies. We used the list of signatories of a letter questioning the UK COVID inquiry.34 UsForThemUK emphasized normalcy of school kids during the pandemic but later advocated also a broader range of policies.34 Finally, HART was a (very) low-intervention pandemic advocacy group that strongly favored keeping children and schools out of the pandemic mitigation and also criticized the mass vaccination policies during the pandemic.34
Wait, what?
An antivax “control” included?
I was dumbfounded when I read the paragraph above. Seriously, Kepp and Ioannidis are citing HART? HART has been spreading pandemic misinformation and antivax lies basically since it was formed. Seriously, leaks into the internal messaging system used by the Health Advisory and Recovery Team revealed that COVID-19 quack Peter McCullough and right wing propagandist Steve Bannon had been involved in the coordination of disinformation messaging with government and media. Its members include quacks and cranks like Dr. Clare Craig and Norman Fenton, and shares members with antivax groups like the UK Medical Freedom Alliance and Robert F. Kennedy Jr.’s Children’s Health Defense. Seriously, do Kepp and Ioannidis not understand that HART is an antivax propaganda organization that has managed to influence the UK government with its disinformation? Yet they include HART as one of their groups and describe it in very mild terms as strongly favoring “keeping children and schools out of the pandemic mitigation” and having “criticized the mass vaccination policies during the pandemic.” No. HART is antivaccine to the core. There’s a reason—many reasons, actually—why Dr. Vincent Iannelli included HART in his list of most popular antivaccine influencers. Yet, to Kepp and Ioannidis, HART is just a group that advocates for less restrictive pandemic policies with respect to schools and has a problem with mass vaccination policies. There is only one proper reaction to the above passage:
Seriously. Here’s a Twitter thread from 2021 that tells you just how batshit antivax HART was and is. I realize that some of you don’t like it when I post long social media threads, but you really have to scroll this whole thread to get a true taste of just how bonkers HART is; so I make no apologies:
One more thing. If you don’t believe HART was always antivax, note that its founder believed in old prepandemic antivax nonsense and the quackery proposed to treat “vaccine injury,” even homeopathy:
And HART has very much been influential among UK politicians and media figures:
Yikes! And this is one of four groups that Kepp and Ioannidis decided to include in their “controls”?
That’s some grade-A bonkers antivax conspiracy mongering right there, as bad as anything I’ve ever encountered anywhere, even from Mike Adams. Yet Kepp at all describe them as reasonable, as merely strongly favoring “keeping children and schools out of the pandemic mitigation,” and as having “criticized the mass vaccination policies during the pandemic.” That alone should tell you that this paper has only one purpose: To portray The BMJ as hopelessly “biased” against the Great Barrington Declaration advocates and their fellow travelers.
Let’s just say that I was relieved to see in Table S2 that The BMJ hadn’t published any COVID-related papers by any of the members of HART. Kepp and Ioannidis apparently view that as a problem. I view it as one of The BMJ‘s few bright spots in terms of science over the last four years.
So what did Kepp and Ioannidis do, along with their coauthors Ioana Alina Cristea and Taulant Muka, do? In brief:
Scopus was searched for items published until April 13, 2024 on “COVID-19 OR SARS-CoV-2”. BMJ publication numbers and types before (2016−2019) and during (2020−2023) the pandemic were compared for a group of advocates favoring aggressive measures (leaders of both the Independent Scientific Advisory Group for Emergencies (indieSAGE) and the Vaccines-Plus initiative) and four control groups: leading members of the governmental Scientific Advisory Group for Emergencies (SAGE), UK-based key signatories of the Great Barrington Declaration (GBD) (favoring more restricted measures), highly-cited UK scientists, and UK scientists who published the highest number of COVID-19-related papers in the entire scientific literature (n=16 in each group).
Funny, how you have to read well into the paper to find out that the antivax group HART was one of the “control groups.” It’s almost as though the authors knew just how antivax HART is and didn’t want to mention them until they absolutely had to.
It also turns out that HART and these four groups are related, with considerable overlap. At the risk of annoying my readers, here’s another Twitter thread:
You get the idea. The relationship between the four groups used by Kepp and Ioannidis as “controls” is quite incestuous. They are pure advocacy groups that appear not to have even tried to publish much in The BMJ. The whole premise of the paper appears nakedly deceptive, with a predetermined outcome that was never in doubt. Here’s the funny thing. COVID-19 minimizers and antivaxxers often accuse those promoting public health of being “astroturf.” Here’s what appears to be a real astroturf operation, with multiple groups with overlapping membership funded by dodgy sources, all promoting the same message, just to different constituencies.
In any event, two figures basically sum up Kepp and Ioannidis’ findings (click to embiggen):
What strikes me the most about Figure 1 is not so much the relative lack of GBD advocates. (Yes, let’s be honest. That’s what Ioannidis means by “restricted measures advocates.”) Rather, it’s the high percentage of journalists who had so many publications on COVID-19 in The BMJ. The other thing that struck me was that, to me at least, the percentages of “radical” supposedly “zero COVID” advocates seems pretty low, particularly when measured as members of the top-100 authors with the most COVID-19 publications overall. Basically, it’s the same false dichotomy that creationists try to use, namely to imply that their view should be represented at a much higher percentage than the actual science can justify.
As for the second graph, I see that indieSAGE members apparently got a lot more editorials/commentaries published in The BMJ between 2020-2023, but they also got quite a few published before 2020, and, surprisingly, didn’t really publish that many more opinion pieces between 2020-2023 compared to 2016-2019. Let’s say, though, that the anti-GBD opinion was “enriched.” Good. It should be. GBD was always a crank position. “Natural herd immunity” through infection (which, let’s faee it, is all that the GBD advocated) was never going to be achievable given that “natural herd immunity” requires at minimum lifelong, or at least very long-lasting, post-infection immunity. It was known very early on that coronaviruses don’t generate long-lasting immunity and are very adept at evolving new strains to evade immunity from infections with prior strains, as evidenced by the Delta and Omicron waves.
Cry “Bias!” and “Favoritism!”
As I like to say, when you can’t win on science, claim that science is biased or that journal editors show “favoritism,” which is exactly what Kepp et al do in the discussion:
Our analysis suggests that BMJ massively published advocate authors championing zeroCOVID policies and later, other indieSAGE-led aggressive approaches to COVID-19 during the pandemic. Leading members of SAGE, highly-cited UK scientists and the most prolific researchers on COVID-19 across the entire scientific literature had very limited BMJ presence compared with the preferred advocates. Advocates of restricted, focused measures have been almost extinct from BMJ pages. BMJ editors, staff and apparently advocate contributors developed a massive literature, comprised mostly of opinion pieces that in general (as acknowledged by the BMJ) underwent no external review in the BMJ. The degree of apparent favoritism exhibited by what is considered to be the premier venue of evidence-based medicine is very concerning and invites further scrutiny.
Again, remember that the rabidly antivax group HART is one of these “advocates of restricted, focused measures” who were “almost extinct from BMJ pages.” Again, good. They should be.
Then there’s the massive projection:
Scientific journals have a responsibility to be balanced, objective, and factual, giving that endorsement of specific ideological or political positions may distort evidence and lead to polarization of the scientific community and loss of trust.20 The intense advocacy by indieSAGE in BMJ was accompanied by UK media publishing many views by indieSAGE, with almost 200 being available on IndieSAGE’s own web page, and these views were sometimes confused with the official SAGE in British media.21,22 This confusion led to exposure of the British population to zeroCOVID advocacy without appropriately recognizing it as such. Given the worldwide influence of BMJ, the impact of this distortion probably had global consequences.
Wait, what? GBD proponents and the HART group engaged in massive advocacy. For example, GBD proponents had access to the ears of officials at the highest levels of government in the UK and US. One might say that the massive advocacy efforts of GBD led to exposure of the British public to “let ‘er rip” advocacy without appropriately recognizing it as such, with the efforts of HART leading to the exposure of the British public to rabidly antivax advocacy without appropriately recognizing it as such. Just sayin’.
Then comes the sour grapes:
Advocacy may be associated also with hostility towards other scientists, both on social media and in BMJ, promoting obsessive forms of criticism.23 In BMJ, SAGE modeling was held co- responsible for tens of thousands of deaths.24 On Twitter/X, UK scientists were also criticized intensely (Table S8).
Oh, yes, I remember reference 23. It’s a paper by John Ioannidis and Vinay Prasad that lamented “obsessive criticism” of scientists on social media. As I noted at the time, my irony meter exploded after observing two tenured academics at very respected institutions complaining about “obsessive criticism” on social media in a peer-reviewed journal for which one of them (Prof. Ioannidis) had served recently as editor-in-chief. Adding to the intensity of the explosion was to see Dr. Prasad lamenting a lack of civility on social media and complaining about “obsessive criticism” given that he is no slouch at obsessive criticism on social media and some rather nasty attacks against his critics himself. Then, of course, Ioannidis had weaponized a satirical publication index to smear the signatories of the John Snow Memorandum who had criticized the GBD as unserious “science Kardashians,” all social media clout, little scientific clout. The irony of someone who did that to scientific critics of a pandemic plan that he believed in is rich indeed.
In the end, the purpose of this preprint is the same as the purpose of the attack on the experts making up the 2022 Delphi panel that published a consensus statement recommending COVID-19 pandemic mitigation strategies. Only the target is different. The idea is to try to delegitimize the target, in this case The BMJ, by claiming bias because it wouldn’t publish articles supporting the scientifically dubious and discredited positions that Kepp et al seem to think to have been unjustly ignored. It’s no different from what creationists do with evolution or antivaxxers with any science or medicine having to do with vaccines: claim that the scientists and physicians that has rejected your viewpoint did so not based on science or evidence, but rather because of ideological bias. This is all the more risibly ironic given how badly The BMJ has done with respect to publishing dreck that supports antivax narratives during the pandemic. In this context, this preprint by Kepp and Ioannidis is not science. It’s disinformation.
4 replies on “John Ioannidis attacks The BMJ as “biased” about COVID-19 in a preprint. Irony meters everywhere explode”
[…] Respectful Insolence: John Ioannidis attacks The BMJ as “biased” about COVID-19 in a preprint. Irony meters everywhere… […]
So, the same guys who lament that kids would definitely be harmed by wearing masks because then they would be breathing in their own CO2 believe that advocating for better ventilation and air quality in schools is radical. Why am I not surprised.
I suppose it’s really time to build better irony-meters. I’m not sure all those exploding irony-meters are good for the environment. Perhaps something with a switch so you can start with a high level and gradually move your way down. A bit like meters used to measure electricity.
[…] on the heels of having seen anti-public health propaganda by John Ioannidis disguised as a study published as a preprint last week showing “COVID […]