Trust me, I'm a Doctor

One of the saddest things for me, personally, has been my almost complete erosion of trust in various institutions over the last couple of years. It would be a fair criticism to say I’ve been largely encapsulated in a bubble of misplaced innocence and naivety for too long. But the astonishing chasm between government, media and health messaging and the data has been too stark, too perplexing, to ignore. Perhaps saddest of all has been my erosion of trust in the medical profession overall.

Today I want to examine an open letter of rebuttal to three of the famous (or infamous, depending on your point of view) figures at the centre of things - Dr’s Malone, Kory and McCullough (I will abbreviate this group as MKM). The letter is written by Dr Hooman Noorchashm and can be read in full here.

The letter is inspired by the recent much higher profile these figures have enjoyed, largely as a result of being Roganned, but also as a result of the recent press conference organized by Senator Ron Johnson.

Overall, the letter reads more like an emotional rebuttal, rather than any scientific rebuttal of the various claims made by MKM. The one piece of evidence presented, a chart from the CDC, is, in my view, highly suspect and not in accordance with data from elsewhere in the world (and certainly not even close to being in accordance with various full analyses of the data). There is a strong element of “Trust me, I’m a Doctor” running throughout.

The letter opens with a short intro and then comes the attempt to persuade that he’s really on the side of reason because he, too, has questioned things.

I will start by stating that I am a vocal advocate for efficient repurposing of generic drugs for treatment of COVID-19 . . . It goes without saying that I am also critic of our federal government’s failure to have done so efficiently — this includes Dr. Fauci, whose virtually monolithic approach to the vaccine and anti-replication agents I find extremely limiting . . .

Additionally, I am perfectly comfortable with the notion of treating infected persons early and supportively, with escalation of therapy as necessary — and I do so in the persons I have had the privilege of treating. The idea of “early treatment” is a reasonable one — knowing also that the vast majority of otherwise young and healthy infected persons do, in fact, recover spontaneously without the need for treatment.

So far, so good. Although note the last sentence here (I have emphasized it in italics). It’s very important for what follows.

The next paragraph is very interesting.

Dr. McCollough knows well that my colleagues and I made a concerted effort in 2020 and 2021, with good success, to test the generic drug cyclosporine as treatment for COVID-19 disease. However, we stopped short of systematizing or marketing its off-label use to Americans, despite our belief that it is a highly effective drug. Because in medicine, acting on belief, gut feeling, or outrage, alone, to create a large-scale systematized treatment algorithms, without evidence from proper clinical trials, will get people harmed and killed.

I can’t properly follow the logic here. The doctor has used a generic drug in his own experimental treatment regimes. Without describing what that success was (75% effective at preventing severe disease? Some other measure?) he then makes the statement that the problem isn’t with using these drugs (as part of a protocol) - it’s in marketing them.

If you do an experiment (trial treatment) and it seems successful - you have evidence. It is no longer just a mere belief. With further study those initial results might not pan out, that’s true, but you now have some evidence that your treatment works. Things have shifted from mere belief at this stage.

He emphasizes the need for proper clinical trials - and I would agree with that, but surely he cannot be unaware of the large number of trials on things like ivermectin and HCQ that have demonstrated efficacy as part of an early treatment protocol? Perhaps the doctor does not think these are “proper” trials as the vast majority of them have not been done in places like the US or the UK. Or perhaps he’s overly-wedded to the idea that we should just ignore observational data until a “proper” randomized control trial has been done?

What’s even more weird is the doctor’s insistence that recommending treatment without these proper clinical trials WILL get people harmed or killed. The doctor used an off-label drug - so, by his own logic here, the doctor HAS harmed or killed people because he did so without proper clinical trials having been performed. You see the Catch-22?

The doctor says that a large-scale promotion, or marketing, of these early-treatment protocols supported by MKM are not justified “without reasonable evidence and real medical consensus”. But MKM have spent a long time and huge amounts of effort detailing the very reasonable evidence they have in support of their protocols.

You will notice that there’s not a single attempt to address the perceived inadequacy of the evidence presented by MKM - just an appeal to authority (the “medical consensus”) and an attempt to smear with vague and unsubstantiated promises that MKM are doing harm and killing people.

The doctor then goes on to say

But what is more concerning to me is that you three do so, while expressing unusual zeal for ignoring the established principles of Immunological science, as licensed American physicians to vocally disparage and dissuade millions of Americans, who have already lost trust in their government and expert institutions, from becoming immunized against COVID-19. This is a critical medical and ethical judgement failure on your parts.

They ignore the principles of immunological science do they? How so? Can you give us examples of where they “zealously” ignore established immunology?

Thought not.

It’s the appeal to authority again - you should trust him because he says so, and he’s a doctor. He provides not a whit of supporting evidence for his astonishing claim. He might be right - I’m not an immunologist - but it’s not acceptable to make a serious claim like this without supporting evidence.

It’s interesting that he notes the loss of trust, and does not blame MKM for that - he says people have already lost trust. Perhaps the doctor might cogitate on the reasons for that loss of trust. One thing he fails to appreciate is that if MKM are right - then it’s absolutely critical to dissuade some people from getting vaccinated with this new crop of “vaccines”. There are many examples where “medical consensus” has failed spectacularly (eg Thalidomide) and also examples of where trust in medics and the government has been spectacularly misplaced (eg Tuskegee).

The doctor then presents a chart from the CDC purporting to show that the vaccines reduce one’s hazard from getting serious illness from covid by up to a factor of nearly 17 at the peak. I very much doubt this figure, for all sorts of reasons (there are some very interesting analyses being done and I will mention just one of several that come to the same conclusion. John Dee, a retired professional data analyst who used to work for the NHS in the UK has been doing some very interesting full statistical analyses of the data and has really struggled to find clear and unambiguous evidence of vaccine efficacy).

He then goes on to say

At a very fundamental level, what you are actually doing is to actively disparage and dissuade Americans from undergoing a preventative treatment that is not only vastly effective at preventing severe illness, but it is now a professional consensus practice — COVID-19 vaccination is now a standard of care as a preventative medical treatment!

Notice that the primary argument here - the one italicized - is to suggest that because vaccination has now become the de facto standard of care it is therefore the correct course of action. It’s an appeal to the authority of the majority. It presupposes that the data surrounding the efficacy of the vaccines is correct and there are very good grounds for being sceptical on that, as I have mentioned.

But what the doctor fails to mention, despite his claim that he has “carefully listened” to hours of the presentations from MKM, is that MKM have, until very recently as more data has emerged, been recommending that those in vulnerable categories be vaccinated. Yes, that’s right. I’ve heard it many times myself. MKM have been recommending vaccination where appropriate.

They have NOT “marketed” their early-treatment protocols as an alternative to vaccination, but as another useful tool in the armoury. The doctor is being woefully misleading and disingenuous here. And note also the intended slur with repeated uses of the word “marketing”. They are promoting their early treatment protocols because they want to save lives and have very good reasons, and evidence, for promoting these protocols. You’ll notice that there is not any attempt by the doctor to rebut that evidence - just an attempt to smear it as “controversial at best”, amongst other things.

No, “at best” it bloody well works!

The doctor might be right - the protocols might not work, they might be harmful (although the evidence clearly points otherwise on both counts) - but he, himself, provides not a single piece of supporting evidence for that assessment. Contrast this with the approach from MKM where the evidence for the statements they make is clearly set out and quoted.

MKM clearly do not rely on the “trust me, I’m a doctor” approach.

Now, there’s another hugely important issue lurking hidden in the background here. Look at the statement of the doctor here “what you are actually doing is to actively . . . dissuade Americans from undergoing a preventative treatment . . .”

ALL Americans?

That’s not true, for a start, as I’ve mentioned they have repeatedly stressed vaccination as a good thing for the vulnerable. But look at the implicit assumption here that it is the right thing to do for all Americans to be vaccinated. Once again we see the everyone is equally at risk perception rearing its ugly, and damaging, head.

Do the risk/benefit calculations work out for every demographic? Maybe they do, but there is no discussion of this, merely an implicit assertion that every American should get vaccinated.

He goes on to say

. . . especially not when the scale of the problem is a massive national infectious disease emergency affecting EVERY American in which IMMUNITY is the critical defence against morbidity and mortality.

But this is not wholly consistent with his earlier statement that “the vast majority of otherwise young and healthy infected persons do, in fact, recover spontaneously without the need for treatment”.

It’s clearly not an “emergency” for certain demographics by the doctor’s own admission. If the vast majority of a significant fraction of the demographic recover, then vaccination is clearly less critical for that group. The data for England & Wales up to 29th Oct 2021 clearly shows that the words “massive” and “emergency” are not at all applicable to the under 50’s. The death registration data from the ONS (the Office of National Statistics) shows that out of about 37 million people under the age of 50 there were 3,729 deaths with covid listed somewhere on the death certificate - so this is an inflated figure of covid death. That’s 0.01% of the population in this group.

I don’t know about you guys, but this does not classify as any kind of “national emergency” for this demographic, in my view. Something to worry about, sure, but not something to completely lose your shit over, either.

The doctor admits that the vaccines have not been universally safe

that these vaccines are more reactogenic than other vaccines in use, and that there is an incidence of adverse events (some devastating) associated with their use has been terrible

Yet, there seems to be not the slightest attempt to check whether, given these acknowledged serious reactions, the vaccine still makes sense for the under 50’s demographic, in general. To do that you need to be able to work out the NNTV (the number needed to vaccinate to save one life, or to prevent one serious illness).

This is one of the points MKM have hammered home time and again. The risk/benefit ratio is not the same across all demographics and in some demographics it does not appear to work out in favour of the vaccine.

There was no attempt whatsoever by the doctor to address this hugely important concern. He carries on in the same vein

BUT, none of these federal failures, . . . justify anyone, especially three seemingly decorated and licensed American physicians, acting to compound the harm to America and American institutions, by disparaging UN-IMMUNE persons from becoming vaccinated. Two wrongs do never make a right!

The doctor is trying to have his cake and eat it here. You can’t on the one hand acknowledge that a younger demographic are not significantly affected by covid, whilst acknowledging the potential for serious vaccine harm, and then recommend they be vaccinated, without addressing the pros and cons. What “harm” are MKM compounding here? If they are right, and I believe they substantially are correct, then it is the vaccine, and not MKM’s advice, that is compounding the harm.

The doctor continues his appeal

The truth is that COVID-19 vaccines induce a powerful Adaptive immune response to SARS-CoV-2 Spike protein in the majority of vaccinated persons. This immune response, though it wanes and requires boosters in some, protects the majority of the vaccinated from severe illness. It protects the majority from becoming infected. It reduces transmission in the majority.

I’ve already touched on the legitimate concerns (based on some heavyweight analyses) surrounding the claimed efficacy of the vaccines in preventing serious illness, but the last 2 sentences here are astonishing. These vaccines have NOT been shown to be efficacious at preventing infection - quite the reverse with many analyses now showing negative efficacy against infection with vaccination. There is plenty of evidence to suggest that the ability to transmit to another, when infected, is also not reduced - indeed, there are indications vaccinations may be making things worse in this regard too.

After some more waffle, the doctor then goes on to say

You are actively and methodically disparaging vaccination in the public square, which is the standard of care in preventing severe COVID-19 illness at the moment. And you are casting doubt on the foundational American science that’s gone into developing this preventative treatment. You are rejecting the scientific and clinical power of the discipline of Immunology, using lopsided rhetorical arguments for the general public.

Once again - unsubstantiated claims and the “trust me, I’m a doctor” approach. We are supposed to just accept that because “American science” has gone into developing these vaccines, foundational science that Dr Malone himself was very significantly responsible for, they are therefore to be trusted.

I haven’t been aware of “rhetorical” arguments made by MKM - lopsided or otherwise - what I’ve witnessed is an attempt to reason through the evidence they present to come to a rational conclusion. The very last thing MKM have been doing is “rhetoric”. They may have drawn the wrong conclusions, that’s possible, but this is just such a disingenuous, and frankly libellous, statement from the doctor.

Almost all of this doctor’s letter is, in fact, “rhetoric”. One is reminded of various kitchen implements like pots and kettles here.

Once again - no attempt is made to address any of the evidence and data presented by MKM and the conclusions drawn by them - just a smearing that amounts to an ad hominem attack.

Then we are treated to some nonsensical reasoning

It may be true that the COVID-19 vaccines have an adverse event rate greater than ivermectin or hydroxychloroquine — it likely is true. Water will have a far lower adverse event rate compared to all of the above. It may also be that these drugs “won Nobel prizes” for other disease processes. But neither their “safety profile”, nor their “prize winning” status, render them magically effective against COVID-19 disease.

He then goes on to say

To suggest such an absurdity to the general public is highly disingenuous.

Well, it’s a good job, then, that MKM have not been suggesting this absurdity, isn’t it? I have never, once, heard any of MKM make such a claim - that because the repurposed drugs are safer than the vaccines they are effective. Clearly, the doctor has been listening to a whole bunch of interviews and podcasts of which I am unaware.

At this point in the letter, I’m beginning to wonder what the doctor’s kickback from Pfizer might be - it really is quite an extraordinarily content-free smear at this stage.

He carries on with this weird idea that MKM suggest their protocols are effective because they are safer than the vaccine

In fact, even if these drugs are “safer” than the COVID-19 vaccine, as Dr. McCollough repeatedly touts, just like water is safer, when you use this “safety” argument to promise or suggest “efficacy”, and then dissuade people who will become infected, from acquiring the preventive shield offered by the vaccine, your messaging as professionals will have caused harm to them — because neither of the drugs you promise (or prescribe/distribute?) have an efficacy footprint anywhere as pronounced as that provided by the vaccine in preventing severe or fatal illness.

What are we to make of this last statement here? The doctor seems to be suggesting that, just because early treatments might not be as efficacious as the vaccines, they should not be recommended. The doctor seems to have got himself a bit deluded into thinking MKM have proposed their protocol as an alternative to the vaccines - when this is not the case at all.

And what doctor, who believes this is a “national emergency”, would not jump at the chance of a treatment that helped, say, only 20% of his patients, quite apart from whether or not vaccines existed. I believe people who have been vaccinated can still get infected and die from covid (although, thankfully, Omicron seems to be really good at the infection part, and much less good at the killing part).

There’s a lot more in the letter, and I recommend you read it in full. There’s nothing to “get hold of”, scientifically speaking. It’s almost entirely made up of unsupported claims and appeals to authority and smears. If the doctor is so worried that MKM are wrong, are persuading millions of people with their arguments, then he utterly fails in his duty to counter those arguments and persuade those millions of people otherwise.

Why are MKM wrong? If, as claimed, they get basic immunology wrong, then explain where they went wrong. Don’t just put words they never said into their mouths and smear them. Don’t just say they’re outside of the orthodox box - explain why the orthodox view is correct.

Respect the dignity and intelligence of those apparently deluded millions by countering the supposed errors directly and let the millions see for themselves what MKM have got wrong (if anything).

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