The One RCT You'll Never See EBM Zealots Demand
"Evidence-Based Medicine" Zealots Don't Actually Care About Medicine or Evidence
With Vinay Prasad set to return to the University of California San Francisco (Psst...sign and share this petition!) after being ousted twice from the Food & Drug Administration in less than a year, having facilitated zero of his much-demanded randomized control trials, it’s worth revisiting the true purpose of “Evidence-Based Medicine” arguments in debates over pandemic policy. As part of what Dr. Jonathan Howard calls the “COVID Amnesia Project,” it seems that much of pandemic punditry has truly learned the wrong lessons. Let’s set the record straight.
One of the worst side-effects of the COVID-19 pandemic has been how academics love to take to social media to demand impossible or wildly unethical randomized control trials, especially in the onset or midst of a crisis. Professing a commitment to “Evidence-Based Medicine,” academics such as Vinay Prasad (UCSF) and Carl Heneghan (Oxford) attacked PPE such as N95 respirators by claiming there was “no evidence” to support their use. They insisted that all forms of face coverings are wholly ineffective in protecting oneself from infection with COVID-19, even going so far to compare the practice to bloodletting.
I’ve said this a million times before, but these accusations imply a major conspiracy: that 3M, Armburst, BNX, and other PPE manufacturers are engaged in a global conspiracy of fraud. It implies that entire scientific fields of engineering and aerosol dynamics are pseudoscience, and just as Hamburg’s chief medical officer insisted about cholera in 1892, nothing can be done to prevent the transmission of airborne viruses. Insisting that their ignorance is the center of all scientific understanding, “Evidence-Based Medicine” zealotry is little more than weaponized stupidity deployed to sabotage public health.
What you will notice is how “Evidence-Based Medicine” zealots refuse to demand Randomized Control Trials to support the use of other medical interventions for other threats to the public’s health. Here in New York City, we just had a major fire in which several firefighters were tragically injured. Using the same logic and arguments used to demand RCTs for COVID-19 interventions, let’s apply Evidence-Based Medicine zealotry to evaluating other forms of Personal Protective Equipment!
Does Firefighting PPE Actually Prevent Burns?
Across America, we regularly see horrible fires that can cause property damage, horrible burns, and even asphyxiation. When fire prevention fails, (of which there are ZERO RCTs evaluating their effectiveness!) firefighters are our last line of defense. Leaping out of heavy trucks covered in bulky turnout coats and often donning a respirator, their hindered movement can mean the difference between life and death for your loved ones in harm’s way. As the recent calamity in Queens reinforces, we have no good evidence that supports the effectiveness of firefighter PPE.
America’s firefighters are plagued by a culture of safetyism, in which incredibly muscular men in the peak of physical health are terrified by the same heat working class chefs face without complaint or protective equipment. Every day in America, children put their hand on a hot stove and make a full recovery, yet grown adult men are living in fear. Obviously, the solution is to generate better evidence over the true effectiveness of PPE solutions for firefighting.
Thus, I am bravely demanding on social media that we enroll 100 fire departments across America in a randomized control trial. Half of them will be allowed to wear full firefighting gear to respond to calls, while the other 50 will be restricted to white cotton t-shirts and blue jeans as part of the control group. Only through applying the rigorous standards of Evidence-Based Medicine can we truly evaluate whether or not heavy jackets are effective in preventing burns, or respirators from preventing smoke inhalation. Otherwise, we are wasting precious taxpayer dollars and risking American lives to enforce a safety-ism culture of unproven interventions.
Critics of such a proposal are obviously mentally unwell & willing to put American lives at risk by mandating ineffective PPE which is not supported by evidence. Burns and smoke inhalation are generally mild and resolve upon their own. Why are we still refusing to learn the most important lessons from the benefits of normalizing repeated SARS-CoV-2 infections across the population? Only “Evidence-Based Medicine” can guide us out of poor-decision making in a crisis.
Why Do This?
The purpose of this exercise isn’t to demand that some of the bravest among us needlessly risk their lives in order to generate data points in an Excel spreadsheet for “EBM” zealots to torture. These supposed champions of “Gold-Standard Evidence-Based Medicine” were so vocal about attacking mitigations against COVID-19 yet never applied these standards to other non-pharmaceutical interventions. Taking advantage of an ignorant and irresponsible media, their goal was purely to promote themselves by sabotaging the pandemic response with reckless disinformation.
These mercenary academics, bankrolled by wealthy interests, have sought to poison the waters in building a fraudulent consensus that the government does not have the obligation, or even the right, to intervene during a public health crisis. That industry is allowed to dictate what degree of public health the citizenry is entitled to, if any at all. This is a phenomenon that has been repeated throughout numerous public health crises dating back centuries. Let us not forget that the precursor to the Great Barrington Declaration, Toby “The Era of Vaccines is Over” Rogers insisted in the early months of the pandemic that hundreds of thousands of his fellow countrymen should have embraced dying of COVID-19 as human sacrifice for “the economy.”
Just as the separation of church and state is a requirement for civic democracy, we also require a separation between industry and public health. Letting the wealthy dictate public health policy has time and time again been a disaster ending in needless death and suffering. Only when universities root out corruption & condemn unethical misconduct, journalists stop legitimizing bad faith propaganda into the mainstream, and when politicians are willing to stand and fight for working families will this necessary change be realized.
