Why Would Any Black American Trust These New Vaccines?

The full, ironic title of this blog post is actually “Why would any Black American trust these new vaccines? A white doctor’s perspective (because, you know, that’s exactly what we need more of),” but it was too long to fit in the title heading.

As a white, male doctor, I am not the best person to write this blog post. Thankfully I am not the only person writing and talking about this, and am in fact a late comer both to the issue of higher rates of vaccine skepticism within medically marginalized communities and to the larger issues of racial health equity and healthcare justice in general. Much of the work that has already been done in this area comes directly from Black physicians, scientists, healthcare workers, and community leaders who are concerned about the disproportional impact the COVID-19 pandemic has had on people of color, and have been working hard on behalf of their communities to verify that the vaccines are trustworthy and effective, and to ensure equal access to this lifesaving intervention.

I believe those voices are far worthier of your time than this post, whether you yourself are a member of a medically marginalized group trying to decide about the new vaccines or, like me, someone who just wants to gain a deeper understanding of the ways that American medicine’s history of racial discrimination and research exploitation have contributed to ongoing healthcare disparities and earned mistrust. That’s why I’ve flipped the usual structure for this post and have placed additional resources and reading as the first proper section, instead of tacking them on at the end or dispersing them throughout the essay. Many of the resources I’ve included come directly from my Black peers in medicine, or our colleagues in research or community health.

So I write about this topic today not because I believe my perspective is the most important one or because I believe I have something particularly unique to add to the conversation, but rather because I believe this issue is so important that we should all be talking about it. Further, I am writing because a certain number of African American men and women have already entrusted me, as their primary care doctor, with the the sacred responsibility of helping them navigate these issues as they make decisions about whether or not to trust the vaccines, and because a good portion of my time over the past few weeks has been spent doing that work. And finally, I am writing because the vast majority of those medical research atrocities that laid the groundwork for the dilemma many Black Americans face today were committed by people within a group I belong to: white, male, American doctors. And even though I claim no kinship with their ilk, and believe that in breaking their sacred oath and committing grievous harm against their fellow man they have forfeited the title of “Physician,” nevertheless I have benefited in various ways from those crimes, and believe that a responsibility rests specifically with white doctors to do whatever we can to bring that history to light and mitigate its consequences. We should not strive to dominate the conversation, as we have so often done; but neither can we stay silent and remain complicit in that exploitation.

Contents:
COVID-19 Vaccine Resources from Black Medical Experts
The Problem: A History of Racist Medical Research Abuse
The Other Problem: The Unequal Burden of COVID-19
My Conversations with Black Patients


COVID-19 Vaccine Resources from Black Medical Experts

If like me you find that you only have a limited amount of time to read today, I would recommend the following resources; you can always come back to my blog post later.
In other words, start here.

Black Coalition Against COVID-19

BCAC19 is a DC area coalition of Black doctors, scientists, healthcare workers, community leaders, academics, and political voices working together to stop COVID-19 misinformation and rebuilt trust in medicine, in order to help Black communities fight the pandemic.

On their website they host public health resources, a COVID-19 FAQ, and town hall videos with medical and community leaders discussing issues around the COVID-19 vaccines.

“Love Letter to Black America”

The Black Coalition Against COVID-19 has also produced this short but important video touching on the importance of trust and accountability in every step of the vaccine creation and rollout process.

Why distrust for COVID-19 vaccines may be higher in African American Communities”

This video and article focus on Jeff Fard, founder of the Brother Jeff Cultural Center in Denver, and his work on combatting the health consequences of COVID-19 on his community. It then branches out to look at what Black-led medical institutions and organizations are doing to support communities of color across the country during the pandemic.

The Black scientist who helped develop Moderna’s COVID-19 vaccine just got her first shot

One of the many excellent articles about Dr. Kizzmekia Corbett, PhD, Virologist and one of the team leads who helped develope Moderna’s mRNA vaccine (the one I and so many of my colleagues and patients have already received).

Personal Essay by Dr. Lisa Fitzpatrick, MD, MPH

A featured essay in Business Insider magazine, written by Infectious Disease expert Dr. Lisa Fitzpatrick. “I’m a doctor who volunteered to get one of the first coronavirus shots. Here’s why I got involved, and what the side effects have been like.”

Waco COVID-19 Vaccine Townhall, 1-21-2021

Local Resource: This is a Waco COVID-19 Vaccine town hall led by African American community leaders, from just a couple of weeks ago. It features Dr. Terri Woods-Campbell, a former teacher from my days in medical residency, and one of several Black, female Physicians who trained me in surgical skills over the years.

Race and the Roots of Vaccine Skepticism

This is a short NPR interview with one of my favorite historians, Harriet Washington, author of Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. She discusses the Tuskegee Syphilis Study, but also the much broader history of medical research abuse and exploitation of Black Americans of which the Tuskegee study was only the most widely known and notorious example.

The Slave Who Helped Boston Battle Smallpox

This one is more academic but offers such an important perspective on the vaccines. It shares an account I first discovered in the pages of Medical Apartheid; the story of an African man known only by his slave name, Onesimus, and how his knowledge of traditional African healing practices and the techniques of variolation saved hundreds of lives from Smallpox and pointed the way toward the future of vaccination science.


The Problem: A History of Racist Medical Research Abuse

I’ll start with a personal story (so bear with me). During my first clinical rotation during 3rd year of medical school, I worked with an upper level resident who despised me. And she had good reasons. I was really struggling academically at the time and my medical knowledge was far behind my peers. Just as importantly, I was a rotation behind them in 3rd year clinicals; it was my 1st rotation, but their 2nd, a lifetime in terms of clinical experience and ability to contribute to a medical team. All of this together meant I was a weak medical student (in medical education we inexplicably still use words like “weak” and “strong” to describe people who struggle with different aspects of the incredible burden of practicing medicine) and, in all honesty, a big drain on her teaching time and resources.

One day during lunch, the program director was lecturing on the history of Gynecology and the techniques and instruments invented by Dr. J. Marion Sims, the “Father of Modern Gynecology,” in Montgomery Alabama in the early 1800’s. The program director posed this question, seemingly rhetorical: “Historically, medical researchers have not always had access to enough volunteers for new techniques and medicines, so who have they used when volunteers weren’t available?” I was a weak med student but I at least had a liberal arts education and knew a little about history, sociology, and moral philosophy, so I answered; “minorities and the poor.” My upper level resident clearly interpreting this as either an off-color joke or even an endorsement of such practices, and generously wanting to save me from immediate expulsion from medical school, shot out her hands in a gesture meant to quell the coming storm and exclaimed to the whole table, “He’s joking. You’re joking, right? Tell them you’re just joking”

But I wasn’t joking, and said so; those groups were exactly who had been used for medical research when the experiments were too dangerous or degrading to recruit volunteers, and it was pretty clear that that was exactly where the program director was headed in that talk. We spent the rest of the lecture learning about the abuse and violent exploitation of poor, Black slave women that had enabled Dr. Sims to perfect his techniques before using them on the patients actually meant to benefit from his research; wealthy whites. These techniques, practiced on slaves without anesthesia and often resulting in infection or other severe complications, eventually made his name famous and led to his becoming the president of the American Medical Association. Only recently has Dr. Sims lost some of the celebration he attained in life because of this history. (The brief slideshow below shows his statue being removed from New York’s Central Park in 2018; you can read about it on NPR from the link provided)

‘Father Of Gynecology,’ Who Experimented On Slaves, No Longer On Pedestal In NYC

But before I run the risk of anyone thinking the above is a story of my wokeness as a medical student (exploitation of allyship, anyone?), I was anything but. I had got the answer right that day (probably for the first and last time during that 2 month rotation) more because I was good at guessing what a lecture was about from the intro than any actual insight into issues of race and justice. I had learned about the Tuskegee Syphilis Study in college, I learned about J. Marion Sims that day in med school; and later during residency I was confronted constantly with the realities of racial healthcare disparities today. And that was it. I was aware of three ‘situations’ out of a 400 year history of abuse, violence, neglect, and exploitation. And for several years, though I grew slowly in this area and fought for healthcare justice 80+ hours a week, I remained essentially ignorant to the actual scope of American Medicine’s racist history (and, you know, racist present).

And if I’m being perfectly transparent and honest, I was at times really frustrated by how my African American patients sometimes seemed to be slower to trust me as their doctor, or to be more suspicious of treatments I recommended, than a lot of white patients. Like many people, I no doubt would have responded to the recent revelation that only 25% of Black Americans planned to get vaccinated against COVID-19 with knowing sagacity; ‘for some reason, Black patients are just more suspicious of modern Medicine. Hmm, oh well… I guess it will always be a mystery.

Then in 2020 a chance recommendation led me to download an audiobook (and then later purchase a hardcopy and an E-Edition) of Harriet Washington’s Medical Apartheid. A keen historian and a lover of science and medicine, Ms. Washington started with J. Marion Sims like we did that day in medical school; but then instead of jumping ahead a hundred years to Tuskegee or Henrietta Lacks, carefully traces a thorough but not exhaustive (as she herself states, that undertaking would take a lifetime and would fill volumes) history of clinical and especially research abuse towards Black Americans, beginning with the medical abuses towards slaves that were so common on the plantation and continuing through emancipation and reconstruction, Jim Crow, the Civil Rights movement, into the modern era and the exportation of medical research abuse to Africa where researchers can more easily get around ethics regulations, and finally concludes in the 1990’s and early 2000’s (it was published in 2006) with exploitative research in topics from drug dependence to human reproduction to criminality, all of which continue to pick and choose data to portray ethnic minorities, and especially those of African descent, as less developed, more aggressive, and in many ways less human (though less overtly than the “research” of the 1700’s and 1800’s) than the “normal;” that is to say, white people.

I’ve been thinking of the best way to distill this incredible, earth shattering, 512 page work into a single section of a blog post, and I’m at a loss. We could choose any of the hundreds of examples she gives in the book as reasons why Black Americans might be slower to trust American medicine than their white neighbors.

One that stood out to me was the section “Racism by Numbers” in Chapter 6 when she discusses the US Census of 1840 which showed significantly higher rates of mental illness and disease in free Blacks compared to those still in Slavery; proof, according to Southern plantation owners and their political allies, that freedom was unhealthy for Blacks, that they were too mentally feeble to handle making their own daily life choices. That scientific data was a huge blow to the abolitionist movement against slavery… Until it was utterly debunked as false and based on horrible methodology and underlying racism, by an African American Physician, Dr. James McCune Smith (the first Black American to earn a medical degree, though he had to go to medical school in Scotland to be allowed to do it) and a white Physician and statistician, Dr. Edward Jarvis. I mentioned listening to Medical Apartheid on audiobook; I was listening to this section during a run, and as someone who spends a considerable amount of my time fighting misinformation, was literally whooping and fist pumping throughout the story of how Dr. McCune Smith and Dr. Jarvis systematically dismantled the failed assumptions and overt racist methods of census takers, who had relied on the reports of plantation owners and slavers to collect data on the health of their slaves, and in many Northern cities reported several times more free “negro lunatics and idiots” (medical vernacular of the time) than the actual total free Black population of those towns. If someone had seen me on my run, they would think I was listening to my favorite team winning a big match; and in a way I was, though in this case even the thorough work of these two brilliant scientists was not enough to erase the damage done by the 1840 census, and chattel slavery continued for another 25 years and only ended with the conclusion of the Civil War.

Or we could look at the display of Black bodies- both living and dead- for popular curiosity and scientific study throughout the 1700’s and 1800’s that she outlines in Chapter 3: Circus Africanus and Chapter 5: The Restless Dead. Or radiation experiments conducted without informed consent on Black Americans throughout the early to mid 1900’s, which she outlines in Chapter 9: Nuclear Winter. Or at Chapter 11: The Children’s Crusade, where she reviews the research conducted throughout the 1990’s attempting to link criminality to genetics and hence to Blackness; research conducted on children and under extremely questionable scientific methodology that strived to prove Black Americans were genetically predisposed towards all manner of violence and anti-social behavior.

But instead of a doomed effort to recreate the progression of Ms. Washington’s meticulously researched review of medical research abuse of Black Americans from the dedication to the epilogue, I want to strongly encourage you to buy a copy and read it or listen to it. Below I share the section and chapter titles, but you have to read it for yourself to discover how richly and clearly she explains the long, relentless violence of medical research towards our Black neighbors, friends, and loved ones.


Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present

Contents

Introduction: The American Janus of Medicine and Race

Part 1: A Troubling Tradition
Chapter 1 Southern Discomfort: Medical Exploitation on the Plantation
Chapter 2 Profitable Wonders: Antebellum Medical Experimentation with Slaves and Freedmen
Chapter 3 Circus Africanus: the Popular Display of Black Bodies
Chapter 4 The Surgical Theater: Black bodies in the Antebellum Clinic
Chapter 5 The Restless Dead: Anatomical Dissection and Display
Chapter 6 Diagnosis: Freedom: The Civil War, Emancipation, and Fin de Siècle Medical Research
Chapter 7 “A Notoriously Syphilis-Soaked Race”: What Really Happened at Tuskegee?

Part 2: The Usual Subjects
Chapter 8 The Black Stork: The Eugenic Control of African American Reproduction
Chapter 9 Nuclear Winter: Radiation Experiments on African Americans
Chapter 10 Caged Subjects: Research on Black Prisoners
Chapter 11 The Children’s Crusade: Research Targets Young African Americans

Part 3: Race, Technology, and Medicine
Chapter 12 Genetic Perdition: the Rise of Molecular Bias
Chapter 13 Infection and Inequity: Illness as Crime
Chapter 14 The Machine Age: African American Martyrs to Surgical Technology
Chapter 15 Aberrant Wars: American Bioterrorism Targets Blacks

Epilogue: Medical Research with Blacks Today.


Though full agreement might be impossible until you have read the book for yourself, it is at least clear to me that the history of medicine in the United States, and particularly of medical research, is sufficient reason for Black Americans to have increased wariness of anything in medicine that is seen as experimental or unproven. But a natural objection presents itself; “But TJ, most Black Americans haven’t read Harriet Washington’s Medical Apartheid, so that history can’t possibly be the cause of their unease or suspicion.

Reasonable enough on the surface, this objection fails to recognize the fact that Black Americans, generation after generation, have experienced medical apartheid, whether they have read Ms. Washington’s seminal work or not. Most American’s have at least heard of the Tuskegee Syphilis Study*, and in a hundred news articles talking about African American hesitancy towards the COVID-19 vaccines you will read phrases like “the legacy of Tuskegee” or “almost 50 years since the Tuskegee study.”

This was from today.

But for Black Americans that notorious series of events is not a one-off episode or anomaly in an otherwise untarnished history of medical altruism and benevolence, but part of a shared cultural narrative of the potential dangers of trusting too readily in scientists, researchers, and lamentably, doctors. Harriet Washington says it better than I can:

It is a mistake to attribute African Americans’ medical reluctance to simple fear generated by the Tuskegee Syphilis Study, because this study is not an aberration that single-handedly transformed African American perceptions of the health-care system. The study is part of a pattern of experimental abuse, and many African Americans understand it as such, because a rich oral tradition has sustained remembrances of pain, abuse, and humiliation at the hands of physicians. We should remember that, as Vanessa Northington Gamble, M.D., director of Tuskegee University’s National Center for Bioethics in Research and Health Care, averred, “many African Americans fear and distrust Western medicine who have never heard of Tuskegee.”

So yes, that ‘25%’ statistic is incredibly disheartening, but it’s also understandable once we know something of the historical context of the relationship between modern medicine and people of color. And while these new vaccines are not experimental and fears of being a “guinea pig” by taking the vaccine really are unwarranted for anyone, those concerns are common among many people of all racial and ethnic backgrounds in our current climate of mistrust and disinformation; and it is not a mystery that those fears might be stronger among Black Americans, with the weight of 400 years of medical and research abuse behind them.


*A note on Tuskegee
I would be remiss if I didn’t at least touch on a the basics of the Tuskegee Syphilis study, though Medical Apartheid does a much better job than I can. This was a study that was run by the US Public Health Service in Macon County, Alabama from 1932 to 1972. The full title of the study was “The Tuskegee Study of Untreated Syphilis in the Negro Male“, and as awful as that sounds it’s probably even worse than what you’ve heard. The public health service initially recruited 600 Black men from among poor sharecroppers in an impoverished county in Alabama; they chose 400 with evidence of latent syphilis and 200 without syphilis as a control group. There were some treatments for syphilis available in 1932 when the study began, but none of them were particularly effective; nevertheless, not even these were offered to the men in the study at any point, even though they were given dummy pills and told they were being cured. The intention was never to cure them, but to carefully observe and document the progression of the disease from its early stages all the way until death, and then conduct post-mortem examinations to see which organs and body systems had been deranged or destroyed by the unchecked bacteria. Of course, this was not only done without consent, but through active and ongoing deception of those involved in the study.

It gets worse. Alexander Fleming discovered Penicillin in 1928, just 4 years before the Tuskegee experiment began; but it wasn’t used clinically until the 1930’s and early 1940’s. It became standard of care for all manner of bacterial infections by the mid 1940’s, and by 1947- 15 years into the 40 year Tuskegee study- was both widely available and a known cure for syphilis. Not a treatment; a cure. The researchers and even the administrators over the Public Health Service met to discuss whether the research project should end and all of the participants be offered Penicillin. Appallingly, they decided that, no, the study would continue. Their reasoning? Now that a cure for the disease had been discovered, this was the only chance to find out what the long-term affects would be if it was left untreated. Please… Stop and process that reasoning for a moment.

The study continued for another 25 years. Participants became wise to the fact that syphilis was now being treated elsewhere with a simple injection instead of countless check-up visits, seemingly ineffective medications, and steady progression of the disease. Many of the men sought treatment elsewhere at other Public Health Service clinics, one of the few places they could receive affordable care; only to find that their names and information had been sent ahead of them. Those in charge of the study had sent a list throughout the Public Health Service network: these men were part of a PHS study; they should not receive treatment for syphilis outside of the study. I hope I do not have to pause here and explain how antithetical this study was to every ethical principle in medicine, every moral imperative towards our fellow human beings. Participants were tricked and lied to, denied effective, curative medication, and then when they discovered the grift and sought care elsewhere they found that steps had already been taken to block their treatment there as well. Some did manage to get treated, by seeking care in other clinics or providing assumed names in order to get the penicillin; but most had already suffered the devastating neurologic effects of late syphilis… Just as the study designers had intended. The study finally ended in 1972 when news of it was leaked by the media (you know, that mainstream media you just can’t trust…); it was popular outrage that finally shut it down, not any moral or ethical consideration by the Public Health Service or the individual researchers, scientists, or doctors that were involved.

That, in a nutshell, is the history of the Tuskegee Syphilis Study. Medical Apartheid’s seventh chapter, “A Notoriously Syphilis-Soaked Race”: What really happened at Tuskegee does it more justice, and by itself is worth the price of the book. That history is more or less known, especially among Black Americans; and even were it just that, wouldn’t it be enough?


The Other Problem: The Unequal Burden of COVID-19

A recent viral video of Dr. Simone Gold, one of the founders of the COVID-19 disinformation group “America’s Frontline Doctors,” featured a long segment where she accuses the CDC of overt racism for stating explicitly that they both aim to make COVID-19 vaccines widely available in communities of color, and for listing strategies to increase acceptance rates and combat vaccine hesitancy in those communities, including recruiting celebrities and other influential people to encourage vaccination.

On the surface, her claims actually sound fairly reasonable; given the history above, any efforts for medical treatments to target specific racial demographics, and especially a historically (and concurrently) oppressed group, has to be carefully scrutinized. Erroneously believing that vaccines are poison, and that these COVID-19 vaccines are “experimental”, Dr. Gold (had she read Medical Apartheid) would make the claim that the CDC’s efforts today are just the latest in the long sequence of medical research efforts that, intentionally or not, resulted in the exploitation, humiliation, and harm of Black Americans.

And she would be wrong.

The key difference, as Harriet Washington herself points out over and over again throughout her work, is that these efforts by the CDC are therapeutic, not experimental. Dr. Gold’s claims about the experimental nature of the vaccines is demonstrably incorrect (see my most recent blog post), as she herself is well aware. Calling them “experimental” or unproven, or referring to vaccine recipients as ‘guinea pigs’, is merely a scare tactic; and one that could be particularly effective when targeted at groups who already have legitimate grievances against American medical research. It goes without saying, but Dr. Gold is also wrong about the vaccines being dangerous; the safety trials were extensive and rigorous, and the protection offered by the vaccines against a horribly deadly virus is excellent. Rather than being a malevolent attempt to test the vaccines on Black people to make sure they are safe for whites, as was the case with Dr. J. Marion Sims’ surgical procedures in the 1800’s and the radiation trials in the 1990’s, this is an altruistic attempt to ensure that Black Americans have equal access to a treatment that has already been proven safe and effective. Finally, in contrast to those experiments, the efforts to address vaccine hesitancy and combat misinformation within Black communities are being done with not only buy-in, but active leadership by Black physicians, scientists, researchers, and public health experts. This is certainly the case on the national level, where organizations like BCAC19 are working with government and healthcare organizations across the country. But it is also being done on the local level in many places. My own clinic has a list of resources similar to the one in this blog that I often provide to Black patients in the context of a conversation about the COVID-19 vaccines and America’s history of racist medical research abuse. It was created specifically at the behest and encouragement of one of our African American physicians, and vetted by a work group dedicated to race health equity.

Treatment, not experimentation.
Beneficence, not malevolence.

Black leadership, not subjugation.

The effort to help Black Americans get vaccinated against COVID-19 is the polar opposite of the very real history of medical research exploitation Dr. Gold wishes to link it to.

But why is it necessary at all? Because despite what Dr. Gold implies in her video by factoring out the health outcomes associated with our long history of racial discrimination, healthcare inequality is a very real factor in America today. And if you need proof, look no further than the data around COVID-19.

Black and Hispanic Americans are far more likely to die of COVID-19 than their white counterparts, and the gap only widens when you factor for age. This is because non-white Americans have consistently faced discrimination and unequal access in healthcare, both individually but especially systemically, and this has resulted in a greater burden of disease for many illnesses and conditions that are independent risk factors for a bad outcome from COVID-19 infection.

Compared to whites, Black Americans are twice as likely to be uninsured. They are more likely to die from cancer despite many of those cancers occurring at higher rates in other groups. The rate of infant mortality is 11 for every 1,000 live births, compared to the national average of 5.8 for every 1,000 live births, and Black mothers are 2-3 times more likely to die from pregnancy-related complications than white mothers. Black men have the lowest rates of survival 5-years after receiving a diagnosis of heart failure. Black men and women are less likely to receive cancer screening and preventative health services. And Black Americans are less likely to have a primary care doctor or clinical home and get their care piecemeal in the emergency room setting, and not surprisingly, consistently report higher levels of distrust in doctors and healthcare.

Dr. Gold and others wish to ignore these factors, to make it seem that there is no need for efforts to ensure the vaccine gets to Black communities. After all, if such efforts are not desperately necessary, they must just be inherently racist. It’s a clever enough ploy, but look at all the history that has to be white-washed in order to eliminate the unequal burden of COVID-19 on Black Americans.

Dr. Gold and others say the difference in death rates between races decreases if you adjust for socioeconomic status and poverty. Manipulating the statistics in this way erases 246 years of chattel slavery, 89 years of Jim Crow, and 67 years of unequal wages, discriminatory hiring practices, and unequal higher education access.

Dr. Gold and others say the difference in death rates between races decreases if you adjust for conditions that increase transmission; crowded neighborhoods, multi-family buildings, use of public transportation, and cramped living conditions. Manipulating the statistics in this way erases 247 years of Black American not being allowed to own property, 67 years of over legal housing discrimination, 35 years of redlining, and 53 years of ongoing housing discrimination even after the Fair Housing Act.

Dr. Gold and others say the difference in death rates between races decreases if you adjust for chronic medical conditions. Manipulating the statistics in this way erases the over 400 years of medical exploitation and ongoing healthcare disparities we’ve already discussed.

We could go on. It’s well and good to say that, all things being equal, the COVID-19 virus doesn’t seem to have any race-based predisposition to harm people of color more than whites. But all things are not equal. Our longterm investment in the destruction of Black Americans’ health is now paying compound dividends, as our seemingly impenetrable barriers to access and long neglect of Black healthcare needs places Black communities in a position of heightened vulnerability to devastation by the COVID-19 pandemic, and our sinister history of medical research abuse rightfully increases the wariness many already feel about the new vaccines, our best protection against it. Those who deliberately spread COVID-19 vaccine disinformation are banking on this dynamic increasing acceptance of their false and fantastic claims, and there is something particularly evil about using the lasting wounds of centuries of medical victimization, neglect, and exploitation of Black Americans to further victimize them by damaging their access (medical misinformation is a healthcare access issue) to the best life-saving interventions we currently have available.


My Conversations with Black Patients

So this is the double-edged sword facing our Black friends, neighbors, and loved ones, and my Black patients; on the one side, ongoing disparities that put them at greater risk from the virus, and on the other a history that legitimately causes mistrust in the best tools we have to fight it. Each and every day in my clinic I am talking with Black patients who are aware of Tuskegee, who are aware of Henrietta Lacks, who are aware that these cases are not isolated incidents, and who are seeing all of the same anti-vaccine propaganda and fear-mongering that you and I are on social media.

Many are not at all fooled. They have been navigating this dynamic their entire lives and are used to making these sorts of difficult decisions. They are well aware of the threat COVID-19 poses to themselves and their loved ones. Many of my Black patients at highest risk- healthcare workers, those who are older or have medical complications- have already been vaccinated through our clinic. We are working daily (a physician friend of mine is working literally day and night) to create vaccine access for still more. Often my patients bring it up without me even asking; “Dr. Webb, when do you think the clinic will have the vaccine available?” Others, when I ask, are excited to be scheduled, or added to our call list for when more doses do come in.

For others (and certainly not just among my Black patients), hesitancy about the vaccines is indeed a factor, and I have been intentional about carving out time in the midst of busy clinic days to have these conversations.

For me, the first step in any conversation about vaccine or treatment hesitancy is acknowledgment, and this is particularly true when speaking with my Black patients. Though I was becoming aware of this area of our medical history for a long time, I was hesitant to discuss it openly, fearing it would come off as insincere or virtue signaling; until one day it just burst out.

I was in the COVID-19 outdoor clinic and discussing a patient’s cough and cold symptoms. My patient, an African American woman, was hesitant to get a nasal swab to test for COVID-19 despite having very classic symptoms (though thankfully her test ended up being negative). When asked about her concerns, she said something I had heard from hundreds of patients of every race, age, gender, and background; “I just have a hard time trusting doctors” (I should mention here that the fact I, a doctor, had heard it hundreds of times points to how widespread this problem is; how many thousands of patients felt that exact way but didn’t feel like they could say it to me?). Normally I would respond by saying “I understand” or “I think a lot of people feel that way, let’s talk about it”; measured and time-honored responses that preempt any defensiveness I might feel and allow the conversation to keep moving forward. But that morning I had gone for a run before clinic and listened to Medical Apartheid for about a half hour, and without thinking whether it was wise, instead I burst out with, “Well how could you as a Black woman, when there’s been so much research abuse by the medical field?!” Before I even had time to consider whether I had just stuck my foot directly in my mouth, she grabbed my arm and said “Yes! Exactly!”

Without adopting it as a stratagem, since then I’ve felt much more free to discuss that history with my Black patients (and not just in the context of the COVID-19 vaccines), who of course already know it but might not think I know it- or am willing to admit it- as a white doctor. And I’ve been disappointed, thought not surprised, at how many times my Black patients have told me it’s the first time they’ve heard a doctor even acknowledge Tuskegee, much less all the rest; historical groundwork that has shaped a huge part of their paradigm for interacting with modern medicine, and their doctors, including me, have never even mentioned it or recognized that it exists. When we confess that history we are working to rebuild trust, and we sincerely signal our intent to do the difficult work, individually and as a field, to correct the abuses of the past and present and ensure they never happen again.

Next, I will often share my personal experience of being vaccinated (and that of my wife, a nurse) with my patients. I received my first dose of the Moderna vaccine on Christmas Eve, and my second just last week. As a healthy, 35 year old man with no major risk factors, even my privileged access to the vaccine is understandably controversial, and there is a strong argument to be made for my doses going to someone who needed them more. I wrestled with this for days before getting vaccinated. Ultimately, I decided I needed the vaccine because as a primary care doctor it is vital that I can look my patients in the eye and tell them I would never recommend that you accept a medical intervention, vaccine, or medicine I wouldn’t take myself or advise for my own family.

This is absolutely true, though it isn’t always possible; so far I haven’t needed my appendix removed or required anti-seizure medications or chemotherapy, yet of course I would recommend those for patients who need them. But it is true about the vaccines, and vitally important in the context of our climate of medical disinformation. But with my Black patients in particular there is an additional layer of significance; to the extent that these vaccines are seen as “unproven” (they are not unproven, just commonly understood as such: safety trials involved 10 times the number of participants than normal vaccine safety trials!), it was important for me as a white doctor to show my patients that I am willing to go first on their behalf, when historically it has been Black Americans that have been tricked or forced into going first in order to protect people who look like me. As Harriet Washington says, it is only since Western Physicians and researchers have abandoned the tradition of subjecting themselves to potential harms before they were willing to subject others that research abuse has become so common.

Then I will spend some time, if the patient has specific concerns, answering questions about the COVID-19 vaccines and helping them see through the misinformation around them. The same legitimate misunderstandings and unanswered questions, wild speculations, deliberate lies and mischaracterizations, and outlandish conspiracy theories that I see every day and try to combat on my blog (see my slowly expanding COVID-19 Vaccine Questions & Answers and more importantly the list of resources there) are being sent to my patients, regardless of their skin color or background. We talk about those myths and I try to use this area of semi-expertise to benefit their decision making as well as I can. I often share a two page handout on the most common COVID vaccine myths, that goes into far less excruciating detail than I do on the blog, knowing my patients can ask me for clarification if they want more information. We also talk about the efficacy of the COVID-19 vaccines, the dangers of the virus, and my firm belief that this is our best path forward out of this pandemic.

Finally, I point my patients towards exactly the same types of resources I shared at the beginning of this article; but here is where my relationship with the patient is a key factor. I have been practicing for 5 years now since completing my residency and have many patients, including many Black patients, who trust me as their primary care physician more than they trust any other individual who could speak into their medical decisions or their healthcare fears or anxieties. Though I will still point them towards the incredible resources that come from my Black colleagues, it is to support the work of trust-building that we have already been doing within our patient-doctor relationship for years. Those resources are influential and reassuring, but my word is also valuable to them specifically because they have seen me work diligently on their behalf and engage with them in a partnership to further their healthcare goals and protect their dignity and autonomy.

Other patients I don’t have that kind of relationship with yet. Either we’ve only had a few visits together or I am seeing them in a context outside of their usual clinic; our COVID-19 outdoor clinic or covering for their normal doctor. In those settings we still work to build trust, but I have to be humble and realistic about how much this can be accomplished in 15 minutes (though you’d be surprised). When I and a Black patient I barely know talk about the COVID-19 vaccines, I explicitly state the fact that we are probably both thinking: that I can’t as a white doctor tell them ‘you should get vaccinated’ and expect to be believed by default, or feel entitled to be believed, by virtue of my title or position, my medical education, or my presumed expertise. And though I hope that through our conversation about the history above and just as importantly through sincerely listening to their concerns and working hard to care for their medical needs I will have built some degree of confidence and trust in my recommendations, nevertheless it is in those situations that I have to lean most heavily on the outstanding work that my Black physician and scientist brothers and sisters have already done in dispelling the COVID-19 vaccine myths and empowering fellow Black Americans to make the best and most informed, empowered choices about getting vaccinated. At the end of those conversations, like the beginning of this blog post, my most important role is getting the resources that have already been created by those Black leaders, without any input from me whatsoever, into the hands of people who share with them a history of medical abuse and subjugation but are striving to claim ownership of their health narratives and use every good tool and resource available to defeat this pandemic and end its inequitable impact on Black Americans.

Dr. Simone Gold and the “Experimental Vaccines”

Introductory Comments
(skip ahead if you just want the minute-by-minute analysis)

Dr. Simone Gold and America’s Frontline Doctors

The video below is going viral right now, spread mostly by private text and social media messages. I’ve had it sent to me by several people in the last week, both doctors who were frustrated with the obvious untruths but too busy (with the pandemic) to formulate a response, and by people with less scientific training who knew the information didn’t sound right but didn’t quite know why.

The talk is from The Stand, a mass faith healing and miracle event put on by known religious hucksters in Florida. False Teachers and theological misinformation are another passion of mine and have been for much longer, ever since I attended a Benny Hinn crusade for a Sociology course. But even though there’s also a pandemic of heresy in the United States right now, it’s the medical aspects of Dr. Gold’s talk at The Stand on January 3rd that we are focused on today.

For an introduction to Dr. Gold and her organization I would encourage you to glance at the response I wrote to their most popular video, a press conference they gave at Capitol Hill back in July. This was the video where Dr. Stella Immanuel from Houston spoke about hydroxychloroquine.

America’s Frontline Doctors (I guess I don’t count?)

This group has been speaking and writing about COVID-19 since at least May, when they wrote a letter comparing the COVID-19 pandemic to a Mass Casualty Event, where presumably the 437,000 Americans who have died from the pandemic so far would be in the “black” category of mass casualty triage; not worth trying to save. The group also includes Dr. Dan Erickson, the California urgent care doctor who spoke out about how the virus is not-dangerous and how most of California had already had it… Back in April. To Dr. Erickson’s credit, his later statements have been much more measured, and based on his sincerity in the original press conference I actually wouldn’t be surprised if he at some point quietly recants his analysis, which was founded on extremely flawed epidemiological assumptions. To date, there have been 40,192 COVID-19 deaths in California.

Finally, you may have read about Dr. Gold’s recent arrest for her involvement in the attack on the US Capitol, which occurred just 3 days after her appearance at The Stand, during which she gave a brief speech again condemning the vaccines and encouraging people to get ahold of hydroxychloroquine. Dr. Gold has since stated that she regrets being involved in that event. My sincere hope for Dr. Gold is that this series of events will force her to consider not just that particular action, but also her stance on the pandemic over the past year as a whole, and to reexamine the evidence, reflect on the harm that has been done by medical misinformation and the people who have died as the result of attending to it, and maybe even become a leading voice for reform from within the COVID-19-denial movement. Dr. Gold is sincere, funny, and winsome as a public speaker; it would be the greatest thing in the world if after this she chose to use her platform to help people take the pandemic seriously and love their neighbors by following common sense, effective transmission control measures.

She, in this case.

Layout of this post

This is a very long post and I don’t expect everyone to read it all the way through. I’ve divided it up into a minute-by-minute breakdown with time stamps for easy reference. If there’s a section of the video you want to read a counterargument or clarification for, just look at the time on the video and scroll to that part of the post.

I’ve also separated it into large sections which I’ve hyperlinked below in the “contents” section. Though Dr. Gold jumps around a bit (that’s not a criticism, I jump around way more when I speak in public), it is possible to separate her talk into some big chunks, so that if you are really only interested in particular topics from her video you don’t have to watch the whole video or read the whole post.

Finally, I’ve included the video itself in my blog post. Just as we have to fight the COVID-19 pandemic on an individual level by providing excellent patient care to those affected and on a population level by encouraging transmission control measures like masking and social distancing, misinformation can be fought in two ways; containing the spread by taking down harmful and misleading content, and by engaging with that content and providing thorough analysis. I have mixed feelings about the first method, and as a primary care engaging directly has been the focus of all of my training and my life’s work. So if Dr. Simones Gold’s video gets taken down on other platforms, it will be up here; and all I ask is that if you are going to watch the video on my blog you’ll also read the blog. Not doing so is tantamount to admitting you are only willing to consider one side of these arguments, and I’m betting that’s not consistent with how you see yourself; all of us want to be fair and reasonable in our judgements.

Contents

Introduction
Dr. Simone Gold and America’s Frontline Doctors
Post Layout (you are here)
1 thing I’m going to do and 1 thing I’m not going to do
3 things Dr. Gold is going to do

Video

Minute-By-Minute Analysis
Part 1: Preliminaries, Hydroxychloroquine, and Masks
Part 2: “Experimental Vaccines”
Part 3: COVID-19 Vaccines and Racial Healthcare Disparities


1 Thing I’m going to do and 1 Thing I’m not going to do

First, I am going to try to be very fair to Dr. Gold in this analysis.
I know that Dr. Gold has a lot to gain from her minority position on COVID-19 issues (becoming the niche go-to medical expert for millions of people who want to believe what you are telling them can be very profitable), but also a lot to lose, which she touches on in the video. Yes, it’s almost a certainty that we will see a book or another political bid from Dr. Gold in the future, and someone whose videos have been shared tens of millions of times and who has successfully sold medication from her website before being forced to stop might sound a bit hollow when complaining about what a risk she is taking by “speaking out”. But the truth is that there is risk. She has been arrested, albeit for her involvement in an attack on the US Capitol and not for anything she has said about COVID-19, and considering everything she has said and written over the past year I’ll honestly be surprised if she keeps her medical license, and I could honestly argue either way as to whether or not that’s actually fair. A doctor friend and I have often morbidly joked that if we didn’t care about morality or medical ethics, we could make lots of money as MD’s; we’ve all seen people do it, endorsing some expensive supplement or offering unproven treatments at exorbitant prices. But I do not believe that Dr. Gold has simply conducted a market analysis and decided there is more money in spreading COVID-19 misinformation than in quietly working as an ED doc, treating disease and alleviating suffering. She must earnestly believe at least some portion of what she has said in this video and has been saying since early in the pandemic, or she would not take the risks; and that is a sympathetic position. I disagree with her on many points, I think it’s pretty clear that she is wrong and why, and that as a physician I think she ought to know better; but I believe she is sincere in a certain way, and wish rather that she could see the truth than that she would simply stop spreading falsehood.

So I’m going to try to be fair. When I perceive that Dr. Gold is speaking from a sincerely held belief I’m going to say so, and when I can’t tell I’m going to assume that she is. We will look at why, in her personal experience and clinical practice, she might be justified in believing some of those things (though as a doctor she has as much access as any of the rest of us to high quality information to put her limited personal observations into a broader context). But there are also times in this video that it is clear she is either lying, engaging in shameless hyperbole, or spreading misinformation she doesn’t believe because she thinks her audience will. Indeed, her conviction in this video seems to be that no COVID-19 myth, no matter how far out, is too ridiculous to include. She basically admits this at several points and I want to be fair and give her credit when we get there; but I’m also not going to shy away from stating that she is almost certainly lying at the times when that is clearly the case. People will die because they attend to this video, and I think being fair to her context and intentions has to cut both ways.

Second, I am not going to rehash arguments that have been made thoroughly and extensively elsewhere.
I’ve written on the evidence of hydroxychloroquine’s ineffectiveness for COVID-19 (Budesonide too) more times than I can count and won’t do it again. Instead I will shamelessly link to my old posts, or better external sources, which you can read if you wish. I’m also not going to argue with every point Dr. Gold makes because she throws out almost every COVID-19 conspiracy theory and myth at some point in the course of the video, even those that have been systematically disproven over and over again. I may touch on masking and other issues very lightly and provide links, and other sections I may skip over almost entirely. This video is 1 hour long and the focus needs to be on the vaccine misinformation, which she begins sharing at about 23 minutes in; so I’m going to pass some things by. Silence does not imply agreement or ceding the point, but I’ve got a full time job and a family I really like, and don’t have 10 hours to spend debunking this video. If there’s a point she makes that you find particularly salient but that I don’t get to, please say so in the comments and I’ll see what I can do.


3 Things Dr. Gold is going to do

I usually like to only debunk/analyze as we go, but this video is so long that we will save a lot of time by touching on the 3 most common “tricks” Dr. Gold uses in her talk. I don’t mean “tricks” as in deception, though some are that; I mean these are debate tactics or rhetorical maneuvers that make her arguments more convincing to the unwary listener without really adding to the actual content of her presentation. I think if you’ll watch the video with these 3 things in mind and can see when she is doing them, you’ll find a lot of this content far less convincing than if we merely reacted to each particular instance.

1. The COVID-19 virus is dangerous or not dangerous when it suits my point.
This is one we’ve seen consistently with misinformation throughout the pandemic, especially from doctors and especially when talking about unproven treatments. The very same doctors who will tell you that the virus isn’t really dangerous and you shouldn’t wear a mask or social distance will then turn around and rely on extremely small numbers of patients to prove that their intervention is the cure, assuming those patients would have had a bad outcome without it.

But you can’t have it both ways. You can’t use a high recovery rate among certain demographics as proof that preventing the virus simply isn’t necessary, and then use a patient in that demographic recovering as proof that your treatment works. You can’t say that the death rate for a 25 year old patient is “0.02%” so you shouldn’t even worry about it, as Dr. Gold states later in the video (will look at the context and impact of these numbers at that time), and then turn around and say that the 25 year old you treated not dying proves your treatment saved their life.

This is a true contradiction, but it’s explicable when you realize that the doctors who hold these contradictory views derive them from two separate thought processes. When talking about the pandemic being blown out of proportion, they are speaking from a political and economic standpoint that wishes, as we all wish, to get life back to normal as soon as possible; the evidence of the danger of the pandemic, which has now killed over 430 thousand Americans, simply cannot change that philosophical belief, no matter how overwhelming the evidence becomes. But when they are talking about their favorite treatment being ‘the cure’ for COVID-19, they are consulting extremely small samples of patients that constitute nothing like substantial anecdotal evidence, much less reliable data. Besides the fact that most of America’s Frontline Doctors are nowhere near the front line (no pay wall but you have to register for that article. Sorry), the way they have admitted to selecting their patients and “diagnosing” COVID-19 make their clinical experiences entirely unreliable. We talked about that more with Dr. Stella Immanuel’s and Dr. Ivette Lozano’s viral videos.

Watch for this as you go through Dr. Gold’s talk. In each section, is she working from the assumption that the virus isn’t really dangerous and therefore you don’t need masks or vaccines, or that the virus is universally deadly and therefore it’s vital that you have access to unproven treatments for it? Most importantly, is she working from a consistent assumption or does it fluctuate based on the point she is trying to make?

2. Everyone is lying to you but me.
I know it feels really calloused to even point this out, but I’d argue it’s more calloused to actually engage in this type of argument. But Dr. Gold does this over and over again. Each time she tells you that historically truthful sources of information like the WHO or the CDC are known for dishonesty or unreliability, each time she tells you that all the doctors and scientists are ‘in on it’ or ‘have fallen for it’ or ‘have drunk the Kool-Aid’, she is saying the traditional sources you would get your health information from can’t be trusted anymore because they are either lying or have been deceived themselves. This is a transparent, mean-spirited, and petty rhetorical trick; it’s also devastatingly effective when you are the one telling people what they want to hear. “Trust me, not them” is not a good standard of evidence, but it works when someone already wants to trust you, as the people she is speaking to almost certainly do. They are comforted because it alleviates the cognitive dissonance of going against the medical experts and what you are being told by people in your own community. If you don’t know them or don’t like them they are lying; if you like them and know them, they have been duped. It gives you a position of both moral and intellectual superiority to believe that you alone are in a position of being both knowledgeable and truthful, and that is the gift Dr. Gold is giving to her audience. It is seductive.

There is also no counterargument that works against it, because if you don’t know me then you can just think that my whole rebuttal is simply lies (ouch), and if you do know me and like me you can think that I’ve been duped myself; that’s the whole point of the ‘you can’t trust anyone but me’ trap. The only way to avoid being deceived by this is to consistently think of this video in the context of your own life and not in a vacuum. You know people who have been harmed by COVID-19, even though Dr. Gold would tell you those were anomalies or they were really harmed by something else altogether. You probably knew people who died from it who weren’t going to die this year otherwise, even though she claims that’s the only people this hurts, people who would have died anyway.

And you know medical professionals. Dr. Gold and a handful of doctors are taking an extreme minority position and telling you that over a million other doctors are wrong or lying; that we are part of the medical establishment and being told what to do by the government, big pharma, and whoever else (by the way, I’ve literally never been told what to do by either the government or a pharmaceutical company when it comes to practicing medicine. Not once). But you know some of those people and you don’t know Dr. Simone Gold. Those other doctors aren’t nameless, faceless, nefarious intellectuals. They are your local Family Medicine doc or Pediatrician you go to and bring your kids to and ask for advice on medical issues ranging from the deeply concerning to the fairly mundane to the kind of embarrassing. They are the nice young resident who took care of you in the ER that time, or the grumpy specialist that nevertheless got to the bottom of your problem. And yes, they are the doctor you didn’t trust or had a bad experience with; but so Dr. Simone Gold’s allies might be. For hundreds of people in Minden, Louisiana, they are that goofy but good natured kid you taught in Sunday School and Youth Group or bought Boy Scout popcorn from for all those years. For some church members in East Texas, they are that son-in-law of the church secretary who visits with his beautiful family whenever they are in town. And for lots of random people across the country, they are that young man who stopped to help you change a tire or gave you a lift when you were hitching, or helped you pick out an over-the-counter medication when you were confused at the local pharmacy even though he absolutely shouldn’t be giving out medical advice in the middle of Wal-Mart. Maybe you don’t know TJ Webb, MD, but you probably knew people as children or as teenagers or young adults who went on to careers in science, epidemiology, and medicine. Those are the people Dr. Simone Gold says are lying to you, and you only have her word to prove it.

That is the context in which you have to think about this claim that ‘everyone is lying’; the context of the real world, where each of those ‘lying or duped’ medical professionals and scientists come from somewhere and have real-life relationships, souls, and histories. We are not a nameless, faceless, monolithic establishment; and disagreeing with Dr. Gold doesn’t make us one.

3. Calling misinformation “truth” and truth “misinformation.”
This is the simplest one but also the most insidious. Dr. Gold spreads misinformation throughout this video, but she is going to claim that her talk is specifically intended to correct or debunk misinformation. This is a false equivalence; she wants to put the information she is sharing, which is believed by a tiny handful of doctors and scientists, on equal footing with the research and clinical experience of millions of scientists, physicians, nurses, epidemiologists, and researchers. Speaking from a widely debunked and extreme minority position, she wants to turn all things COVID-19 related into a ‘he said / she said’ situation and ask you to choose between the two as equally valid and scientifically supported views.

And in a way that’s ok; when presented with false information like that which Dr. Gold shares in this video, you really should decide for yourself based on the evidence. But please keep in mind what the implications are of accepting one or the other. If you decide that Dr. Gold is truthful then you are in effect saying that you agree that there is a wide-ranging conspiracy to deceive the public and cause mass suffering, which involves almost every single doctor, nurse, and scientist you know. And if you believe that, that’s fine; some people do prefer conspiracy theories, or even just want that to be true because it would mean that life could get back to normal sooner. But let’s not pretend that the real life experiences of millions of generally altruistic doctors and nurses is equivalent to the fringe view of a few overtly political physicians. At the very least, the burden of proof rests with the latter.


*WARNING*
The Below Video Contains oh just tons of incorrect and misleading information.

If you are going to watch the video, please also read a counter-argument; either mine or someone else’s.


Minute By Minute Analysis

Part 1: Preliminaries, Hydroxychloroquine, and Masks

0:39 “Experimental Vaccines”
Well that didn’t take long. Dr. Gold will consistently call these vaccines “experimental” because all of us are afraid of being guinea pigs in some science experiment. She is mischaracterizing them and we look at that in detail later on, but she wants you to adopt her terminology now because even the idea of the vaccines being experimental will convince some people not to get them. People will die because of this video.

1:03 America’s Frontline Doctors
Dr. Gold’s organization has been spreading misinformation about the pandemic for going on a year now; here is the first instance of her claiming that they are trying to combat it. Truth is lies, lies are truth.

1:25 “Groups of physicians, scientists, and government agencies lying to the American people”
This is the first instance of “everyone is lying but me”, but certainly not the last.

1:50 ‘The NIH is lying when it says that unless you are in the hospital requiring oxygen there is no treatment available
Dr. Gold is going to spend the next few minutes talking about hydroxychloroquine, and you can read my analysis of these claims in any of the many posts where they’ve already been addressed.

But this claim specifically is that the NIH says there is no treatment unless you are in the hospital and on oxygen. Well, here are the NIH treatment guidelines, and I’ve included their summary table below.

For patients with mild to moderate illness who are not hospitalized, there is some decent evidence of monoclonal antibody therapy and I have referred several patients for this just this past week. This is the same treatment then-President Donald Trump received when he had COVID-19. For patients in the hospital and not receiving oxygen, they recommend remdesivir for those with a high risk of disease progression. And of course, for all patients we are providing counseling on over the counter treatment, supportive care, and anticipatory guidance when they are seen, which any doctor would tell you are the mainstays of treating any illness, whether specific medications are prescribed or not.

So, 1 minute and 50 seconds in we have our first example of Dr. Gold giving a demonstrably false statement. The proof is before your eyes; the NIH treatment guidelines do not say no treatment is available unless you are in the hospital and on oxygen. Will you still give her your absolute trust for another 54 minutes?

2:20 “We were promptly de-platformed”
This is true; there is no denying that the America’s Frontline Doctors Capitol Hill speeches, and most famously Dr. Stella Immanuel’s hydroxychloroquine speech, were taken down from Facebook and YouTube. Again, as that video was full of dangerous misinformation, it’s hard to feel bad about it; but it certainly lends credence to their claims of censorship (by private companies and not by the government, but still) and in certain peoples’ eyes lends an air or forbidden truth to their comments.

I would much rather have the arguments understood and then analyzed. I wasn’t able to post a video of that talk but you can read the transcript and my analysis here.

2:29 “This is a crime against humanity.”
Wait, YouTube taking down their video was a crime against humanity? Hmm…

I’m being facetious; she clarifies that it’s the massive disinformation campaign around COVID-19 that’s the crime against humanity. I happen to agree with her, but we fundamentally disagree about who is a part of that disinformation campaign.

2:52 “The vast majority of deaths in America would never have happened.”
Uncanny, we absolutely agree again. When you look at the death rates around the world, every nation, and especially those that took the pandemic very seriously early on, has faired much better than the USA. But the key is prevention of transmission with masking, social distancing, and now vaccines; not ‘give everyone hydroxychloroquine’.

When in your life have you heard a doctor say it’s better to get a deadly disease and then treat it than to avoid getting it in the first place? We are accused of that all the time, but I’ve never actually seen it happen until now. Again, the treatment she is espousing here doesn’t actually work, but that’s beside the point. The very people who will share this video where Dr. Gold promotes unproven treatments and warns against safe vaccines will un-ironically go on to post comics like this one:

Our first day of medical school was actually just a bunch of ice breaker games and a super annoying scavenger hunt that we lost because my friend Jason kept on getting lost, but whatever.

3:09 “You need to understand the magnitude of the lie…”
What Dr. Gold is doing here (besides helping fill up her hour, which can be a real challenge sometimes), is repeating to a select audience- both those at this faith healing event and those sharing her video on the internet- misinformation and conspiracy theories they already agree with. This helps solidify her position as a truth-teller and lends additional credibility to the real point of her talk, the concerns she is going to share about the vaccines later. We will go through them as quickly as possible.

3:26 “Its real name should be…”
There’s no important information or misinformation here one way or the other. We do not universally name diseases after their location of origin, though it is sometimes a factor, just like the person who discovered it is sometimes a factor in naming. If anything, we are getting further and further away from eponyms in medicine, and where many people would have talked about “Hansen’s Disease” in the early 1900’s, nowadays we just say “leprosy” like they did in the Bible, except for a few test questions during second year of medical school. Naming conventions for diseases in the age of microbiology focus more on either the name of the pathogen or the syndrome that it causes.

For instance, the name of the dangerous Coronavirus disease that was first identified in Foshan China in 2002 was “SARS”; Severe Acute Respiratory Syndrome; it was never called the “Foshan” virus. In contrast, the next dangerous Coronavirus we encountered in 2012 was called “MERS”; Middle Eastern Respiratory Syndrome, based on the region it was discovered in. The name of the novel Coronavirus we are fighting tooth and nail against now is SARS-CoV-2; Severe Acute Respiratory Syndrome Corona Virus 2, because, you know, it’s the second one. The name of the syndrome is COVID-19 for Coronavirus Disease 2019, which I admit is a little bland for something that has devastated the world.

The only times the virus is called the “Wuhan Virus” (or the more overtly racist “Kung Flu”) is by those who wish to make a political statement; calling it the “Wuhan Virus” is politically or ideologically motivated, not the other way around. Here Dr. Gold is simply making a show of solidarity with those who would like to call it what former President Trump often called it; there is no important ground here, only signaling to her audience which team she is on.

3:38 “Before we discovered…”
What was discovered was that it is a coronavirus similar to the one that causes SARS, not that the Chinese government didn’t like the name “Wuhan Virus.” Remember, it is called COVID-19 and SARS-CoV-2 around the world; the narrative that the US is in China’s pocket (not my field of expertise) simply does not explain the naming conventions for the pandemic.

3:55 “They called it a coronavirus because it is a coronavirus, but that became very confusing to doctors and scientists…”
Nobody was confused. This whole narrative is really weird and insincere.

4:03 “We used to use coronavirus on our charts when we meant a common cold.”
Look I realize I am splitting hairs here, but no. If you did a viral respiratory panel and it showed a coronavirus, sure, you would document that; but otherwise we call those colds “viral upper respiratory infection” or just “cold”, or if it is causing a more specific clinical picture, “viral bronchitis” or “viral bronchiolitis”, etc., or if we are really being lazy just “cough, sore throat, and rhinorrhea (runny nose)”.

When I started listening to this last night and Dr. Gold got to this point, my wife (a Registered Nurse) called out from the other room, “Did she just say we use ‘cold’ and ‘coronavirus’ interchangeably?!” Yes, she did. And no, we don’t.

Again, it’s a non-issue, but I was annoyed by it. Sorry, moving on…

4:59 More Hydroxychloroquine
I’m really going to limit myself to a few comments on this section because I’ve already linked to my other hydroxychloroquine articles above. The biggest things that stick out here:
5:11 We don’t give any medicine out like candy.
5:18 Treatment and prevention of Malaria is a common use of chloroquine and hydroxychloroquine because they have been proven to be effective against that disease. Comparing this to using it to treat COVID-19 is like saying you don’t understand why a doctor won’t give you penicillin for your high blood pressure when they give it out all the time for strep throat. Carefully deciding which medications to prescribe for specific conditions, and then carefully discussing the risks and benefits of them with our patients, is modern medicine. Is Dr. Gold really saying that if a medicine is helpful and safe for some people and conditions it’s helpful and safe for all people and all conditions? If not, then surely she would admit that we have to follow the evidence here.
5:48 I really shouldn’t have to say this, but the key difference here is that Malaria is common in Sub-Saharan Africa and uncommon in the US. She says it herself, but the issue isn’t consumer demand but rather the ubiquitousness of the disease it treats. That said, if hydroxychloroquine really were the miracle drug for COVID-19 that Dr. Gold and others have claimed, I’d join them in calling for it to be OTC with appropriate pharmacist warnings. Sadly it isn’t.
6:43 We have not been hearing about it being unsafe for 10 months because of an organized misinformation campaign against hydroxychloroquine. Does she ever offer a credible theory as to why such a thing would happen, why doctors wouldn’t want patients to have access to this medicine if it worked? The truth is we heard about it 10 months ago as being something we were hopeful might work, and then were sad when the evidence showed it didn’t. We’ve only continued to hear about it since then because doctors like Dr. Gold continue to build conspiracy theories around it.
6:51 “You’ll be suspicious of everything that follows” And that is the point of it being included in this talk.

7:15 “She was so much better”
Here the virus is dangerous, which proves hydroxychloroquine is effective because this patient got better.

7:33 “My medical director called me the next day”
I absolutely will not try to dissect Dr. Gold’s personal experience here and claim that either she or her medical director was in the right. For one thing, we simply don’t have enough facts, we don’t even know what point in he pandemic she is talking about; I know some very good doctors who were using hydroxychloroquine back before any major studies had been done because there was hope the evidence would show it was effective. Those doctors don’t prescribe it anymore, because they have been convinced by the evidence.

What I do want to say is that her example of the medical director coming to her seems intended as a callback to horror stories we have all heard about a hospital administrator or business consultant telling a doctor or nurse how to practice medicine, usually motivated by profits. That is wrong every time it happens, and those people deserve to get fired, fined, and in some instances, serve jail time. I’ve never had one of those situations, but I’ve been in some that came close.

But this isn’t one of those stories. My medical director is an excellent physician who has been practicing a lot longer than I have; I often go to her for professional and medical advice. If she were to offer feedback or even correction on some treatment I was providing that was not supported by evidence or seemed to be due to political motives rather than evidence-based medicine, that would be part of her job. I might not like it. I could argue my case. I could appeal to any of a number of internal resources. I could lay down the gauntlet, do it anyway, and let the chips fall where they may. But I could not accuse her of overstepping her bounds. When she says this is against the law or an example of a ‘corporation practicing medicine for her’, she is knowingly wrong.

7:55 “You haven’t read the science the way I have, you’ll change your mind in a couple of months when you get a little wiser.”
Yikes. I’d say ‘that didn’t age well’ but she just said this 2 weeks ago.

8:38 “The reason he said I shouldn’t prescribe it was because the insurance company didn’t want us to.”
Nope, I don’t believe this for a moment, for 2 reasons. First, Dr. Gold is shamelessly promoting a well worn lie that pharmaceutical companies tell doctors how to practice medicine. It’s commonly believed, it crops up on tv and in movies constantly, and it’s almost an underlying assumption in many peoples’ interactions with healthcare; and it’s 0% true.

I spend countless hours each month helping my patients navigate around their insurance company’s arcane pharmaceutical rules and find the best way to afford their medicines regardless of their insurance status. I often prescribe a medication to one pharmacy, and then print the prescription and a coupon for another pharmacy in case the insurance doesn’t cover it. I pull up GoodRx.com or the Wal-Mart $5 generics list and we tally up the cost of their meds to find the cheapest price and make sure they can afford it. You know what I’ve never seen a class, a lecture, or even a powerpoint slide on and have never given a hoot about since the first day of medical school? Pharmaceutical or insurance company profits. Don’t confuse the broken system with the people who are fighting against it every day.

But the second reason is a lot more straightforward; they are in the Emergency Department, not inpatient in the hospital. The patients are filling their prescriptions at some pharmacy somewhere separate from the hospital, and the medication costs about $15 for a month supply with a coupon; the insurance company doesn’t have to pay for it if they don’t want to, and the ER docs will probably never hear about it. So any intervention or confrontation over this medicine was almost certainly because of the paucity of evidence for it working, not because of financial issues. If Dr. Gold at some point shows documentation that confirms this narrative, I’ll be shocked; I’ll also publicly recant this objection. But it seems to me that she is just retracing a well trodden but false narrative about the toxic control that pharmaceutical and insurance companies have over doctors.

9:17 “My days at that particular hospital were numbered.”
Listen, I can relate here; I once quit an ED job because of financial issues too. The issue? I found out that ER company was sending their patient’s bills directly instead of going through insurance, and worse, marking up the charge for physician services by about 150 to 300%. I never scheduled another shift. So even if her narrative above isn’t true, if she felt that it was I could empathize with her feeling like her career at that hospital was done.

10:22 “It got 20 million views because human beings recognize truth.”
I would be very, very careful about arguing that views=truth. I’m sure there are a lot of youtube videos out there that engaged in less than perfect truth telling but do pretty well. But it’s a nice thought.

13:00 “You have to push back against tyranny.”
Dr. Gold is here advocating against wearing a mask and comparing it to tyranny without offering a single scrap of evidence. The evidence that masks help prevent the spread of COVID-19 is absolutely overwhelming (it’s dated, but it was overwhelming when I first wrote about it back in June, and the evidence is only stronger now). This misinformation video and others like it will cost lives; but she is talking to a group of COVID-19 deniers and advocating for masks, or even remaining neutral, isn’t an option for her.

13:24 Not wearing a mask on behalf of others is a very strange argument.

15:00 “Whether you have COVID or you don’t have COVID you can get yourself a prescription…”
That’s called a pill mill, folks.

15:38 “People just want to go back to normal lives.”
Dr. Simone Gold is absolutely correct here. It’s one of the reasons this medical misinformation is so very seductive, because it speaks directly to our hopes; specifically our hope that we can finally be done with all of this. But the question isn’t whether or not we should be afraid; we shouldn’t. It’s whether our actions are kind and wise, and that in turn is based on whether our information is actually true. Every day, with every patient I test for COVID-19, I tell them not to be afraid; and then we talk about how they can protect themselves and their loved ones from this very dangerous virus.

16:17 “The vaccine doesn’t stop transmission.”
If I get the vaccine, can I still transmit/spread the virus?

16:21 “It actually changes nothing.”
Again, this simply isn’t true. Vaccines are still our best path out of the pandemic while limiting death and suffering. If you are vaccinated, your risk of both death and long-lasting medical side effects from the virus is significantly lower. If your grandparent is vaccinated, your risk of giving them the virus and them dying from it is incredibly lower. No, a few million people having the vaccine has not yet changed the pandemic substantially for everyone; but thankfully that is the path we are on.

17:03 “According to the CDC which is not known for it’s honesty.”
“Everyone is lying to you but me.” There have been multiple examples where the CDC has published confusing, conflicting, or poorly communicated information throughout this pandemic. Sometimes that was because of incompetence, other times because the best information available was just changing so rapidly. And at other times it was because high ranking officials in the Trump administration, with no medical background, were controlling what information was being put out.

If you have any specific examples where the CDC actually lied to the American people during this pandemic, please leave them in the comments. Let’s not just take Dr. Gold’s word that all of the hard working scientists, doctors, and public health workers at the CDC are liars become she’s telling us information that tickles our ears.

And by the way, if you want to see how these numbers Dr. Gold is getting ready to share compare to what the CDC has been saying for months, have a look at this graphic from as far back as October. Don’t let someone tell you’ve been lied to when you haven’t been; check the original source.

17:07 Survival Rate by Age
At this point Dr. Gold spends a few minutes talking about the survival rate for COVID-19 for various age groups. Earlier when talking about hydroxychloroquine the virus was very dangerous; it was remarkable that her patient got better after taking the medication. Now the virus will become benign again except for small percentage of the population.

There are some fine points of epidemiology that we are going to have to guess at since Dr. Gold doesn’t give us complete information. For instance, we will assume she means the Infection Fatality Rate, which includes estimates of asymptomatic carriers of the virus, rather than Case Fatality Rate, which is just those who develop the COVID-19 syndrome; it’s the lower number and, for the point she is making, the best one to use. We also don’t know where she is getting her numbers from, as we will see in a minute.

Two more tricks to look out for (again, I don’t mean ‘tricks’ as in intentionally deceptive, just that these are rhetorical tools to make the data better reflect her side of the argument). First, Dr. Gold is going to give you the survival rate, not the mortality rate. This is incredibly important. When Dr. Gold tells you “95% of people over 70 survive,” you are reassured; the way that is phrased, it’s easiest to see yourself or your loved one in that 95%. If you were to say “5% of people die,” you would be sharing exactly the same information, only now it is too easy (for Dr. Gold’s purposes) to see yourself or your loved one in the 5% group that will die; you might want to take some precautions, like wearing a mask and social distancing, which in general Dr. Gold is against. Indeed, when I read survival rates like 99.5% and 95%, I get really worried; those mortality rates are just astronomical compared to any virus we normally face.

Second, Dr. Gold is grouping all ages from birth to >100 into just 4 age groups. This is going to skew the numbers quite a bit. For instance, if you are 49, your ‘survival rate’ is averaged with those who are 22; but you know (just like I do at age 35) that your resistance to illness and ability to recover from infection is not the same as a 22 year old’s. I don’t think Dr. Gold is being deceptive here; she has a one hour talk and has to make the most of it, and a nuanced discussion of these numbers would take more time. Still, I think one reason for choosing such broad age groups is because the numbers fit her narrative better when they are presented that way.

17:07 Under age 20: Survival Rate 99.997%
Dr. Gold states that these numbers come from the CDC. You’ll notice she doesn’t say the same for any of the rest of the numbers, so I’m not sure if she is using the same source or different sources. But overall this agrees with the most up-to-date research on Infection Fatality Rate. One word on Infection Fatality Rate: Because you have to know how many asymptomatic cases there are (and we don’t), IFR is incredibly hard to calculate. The numbers will fluctuate some based on what method is used to estimate the asymptomatic cases. Throughout this part of the analysis I’ll present a few different studies that arrive at slightly different numbers; but that’s a good thing. Just like minor differences in the Gospels that complement each other is a proof of their authenticity, so different scientists arriving at slightly different numbers by using different techniques is a good way to know the numbers are, in general, reliable. If you had multiple scientists getting exactly the same numbers with different methods, you’d be suspicious; and you’d be right to be. Small differences are a good thing, and just one more proof that the scientific establishment isn’t pushing some big conspiracy on you.

So the Survival Rate for people under 20 is 99.997%. The US population under 20 is about 80 million, so that’s about 2,300 at risk under 20, if our estimates are accurate. So far, we’ve lost about 650 Americans under age 20 to COVID-19 (the CDC uses different age groups from Dr. Gold, so we can’t compare apples to apples here), including two children under 10 years old in Fort Worth, an hour North of here, just a few days ago. Dr. Gold says “There’s nothing to talk about” in this age group, but these are not negligible numbers. Without mitigation, we stand to see four times that number of deaths, even assuming the new variants are only as dangerous as the original COVID-19 strain.

Second, you can’t group 3 year old and 9 year old children together with older teenagers. At age 18, the Survival Rate is closer to 99.992; a mortality rate three higher than that in children.

17:15 Age 20-49: Survival Rate 99.98%
Accepting Dr. Gold’s numbers, this means that 25,400 Americans age 20-49 would be at risk; so far we have lost… about that many. So now we need to look closer at these numbers, since something is clearly off, and unlike for the birth-20 age range we don’t know where these numbers came from.

A detailed Meta-Analysis published in Nature in November estimates mortality rate for people age 20-24 at just under 0.01%, and for people age 40-49 at 0.1%; a ten fold difference. Clearly, it doesn’t make much sense to group 20-49 year olds together as one age category. 0.1% is a high mortality rate for a very, very contagious virus like SARS-CoV-2; it means that about 20,000 people are at risk in that age range. If we combine census data with the IFR estimates, we get these estimates of how many Americans would be at risk in this age range:

  • Age 20-24, IFR 0.008%, population 21.63 million
    • 1,730 at risk
  • Age 25-29, IFR 0.011%, population 23.5 million
    • 2,585 at risk
  • Age 30-34, IFR 0.03, population 22.43 million
    • 6,700 at risk
  • Age 35-39, IFR 0.075%, population 21.73 million
    • 16,300 at risk
  • Age 40-44, IFR 0.09%, population 19.92 million
    • 17,900 at risk
  • Age 45-49, IFR 0.11%, population 20.4 million
    • 22,400 at risk
  • Total Estimate from Dr. Gold’s Survival Rate: 25,400 at risk
  • Total Estimate from Meta-Analysis Infection Fatality Rate: 67,615 at risk

The mysteriously high survival rate Dr. Gold quotes when clumping together 20-49 year olds give us 25,400 Americans at risk in that age range; comparing the US population with the IFR estimates for much smaller age rangers gives us a total of 67,615 at risk 20-49 year olds. Now, we all hope that herd immunity, whether from infection or from vaccination will mean that we will never see this many deaths among this young demographic; but Dr. Gold’s incredibly low estimates of the danger of COVID-19 in this age group provide a false reassurance and bely how many lives will be saved from mitigation measures, masks, and vaccines.

We won’t get to it, but later on (at 41:40) Dr. Gold says that the only people who are dying of this are your 80 year old nursing home residents with bad hearts and other medical conditions, “It’s not your 45 year old nurse, it’s not your 35 year old police officer.Except that sometimes it is.

17:20 Age 50-69: Survival Rate 99.5%
I won’t go through the numbers for every 5-year age group again, but the further up Dr. Gold gets in these age ranges the further off the survival rates she is quoting seem to be. She quotes an infection fatality rate of 0.5% (Surival Rate 99.5%=Fatality Rate 0.5%) on average for this age range, but this is closer to the fatality rate for 55 year olds. By the time you get to 65 it’s at least 1.1% and as high as 1.4% by some estimates, which is a survival rate of 98.6%. If that sounds like a good number to you, consider the population in that age range; there are over 17 million Americans aged 65-69; that survival rate means that 240,000 of them are at risk of dying without mitigation measures.

We could do the same thing with Dr. Gold’s 95% survival rate for people over 70; that’s the survival rate for 75 year olds, not for everyone above 70. The IFR increases to as high as 15% at age 80, and continues to increase with age; that means millions of Americans are still at risk in this elder population, not to mention the hundreds of thousands who are at risk who are younger.

But even more important than all of these numbers, the fact that Dr. Gold is ignoring, which we’ve talked about over and over again on this blog, is that what makes the pandemic most dangerous for young people is its ability to overwhelm our medical infrastructure. Overwhelmed hospitals, exhausted doctors and nurses, more patients than the staff can possibly provide care for; these factors make COVID-19 extremely dangerous regardless of the Infection Fatality Rate. The COVID-19 survival rate plummets when you can’t get medical care for a severe case of the virus; but so does the survival rate of motorcycle collisions, pneumonia, diabetic ketoacidosis, gangrene, broken hips, closed head injuries, and knife wounds when you can’t get care because there are so many cases of this highly contagious virus. COVID-19 overwhelms healthcare systems and makes everything more dangerous, including itself.

17:55 “The people who die from COVID-19 are the people who are destined to die anyway.”
This is simply not true. I dare Dr. Gold or anyone who believes this to look the families of those who have passed from COVID-19 in their 70’s, 60’s… or 30’s, 20’s, or teens in the eye and tell them that person was destined to die anyway.

But I know what the counterargument will be; “those people really died from something else and it just got counted as COVID-19.” We’ve addressed this in detail before when we looked at information from COVID-19 death certificates a few months ago; those deaths really are from COVID-19. But it doesn’t fit Dr. Gold’s narrative of ‘only the old who are already dying will die from COVID’, so regardless of the facts those deaths have to be discounted. I’m not willing to discount them. 

Besides the data we’ve examined above that shows the non-negligible death rates in those in their 20’s, 30’s, etc., and the actual data you can go look at for yourself, which shows a steady progression with age and not a steep increase when you reach 80+, there is one more important piece of evidence that disproves Dr. Gold’s “people who die from COVID-19 would have died anyway” narrative, and it’s something called excess mortality. If most patients who died from COVID-19 would have died this year anyway, as the narrative dictates, then we would see little fluctuation from year to year, including 2020. 

In fact, there’s a meme with false numbers circulating on social media that claims just that, and in fact claims that the number of deaths in the US was lower in 2020 than recent years. The popular one looks like this, but I’ve been arguing with people about these numbers for a couple of months now.

One of the reasons this is convincing for people is because, in general, we are bad at estimating. Even though the deadliest month of 2020 was December, when 2,000 to 3,000 people were dying from COVID-19 per day, this data from November 22nd seemed to convince a lot of people. That’s with 39 days (10 percent) of the year left, and the deadliest days of the pandemic (at that point) to boot. But it’s actually even worse than that; this is based on data currently reported at the time, not data that had been finalized; and it takes up to 8 weeks to finalize the death count for a particular week in the US. So really, this chart is only reflecting the total deaths from about September 27th. Lest we forget how much things changed between the end of September and the end of the year:

The real numbers are much more dire, but don’t tell us anything we didn’t expect; a lot of people predicted that the US would lose over three million people for the first time ever, as far back as October and November when number of daily cases and deaths began to rise. The real number is 3,200,000, and at least 347,341 of those deaths were from COVID-19. And remember it’s only January 31st; we’ve still got another 3-4 weeks before we’ll know the final death count for 2020.


Part 2: “Experimental Vaccines”

23:10 “You definitely shouldn’t be calling these the COVID-19 vaccines.”
Dr. Gold prefers to call them “experimental biologic agents,” which honestly sounds like a term people might use for psychedelic mushrooms when they don’t want anyone to know that they are using psychedelic mushrooms. I think she’s trying to invoke Agent Orange and other biologic weapons here. But the good news is you can go ahead and call them “vaccines,” because they are vaccines.

23:17 “It is currently in it’s investigational stage.”
A lot of Dr. Gold’s vaccine information is going to try to hype up fears about the vaccines being experimental, untested, or unproven. We all worry about being ‘guinea pigs’ for modern medicine, and depending on your personal experiences, your race or ethnicity, or other personal characteristics those concerns may be very historically grounded. Thankfully, these vaccines are not experimental; not by a long shot. The vaccines have been through rigorous safety trials that were much, much larger than normal. Most trials for new vaccines have between 3,000 and 6,000 participants; these vaccine trials had 40,000 to 60,000. More to the point, about 30 million people have already been vaccinated in the US alone, including the author of this blog. In a minute when Dr. Gold says “I don’t want to be the first person to take new things…” Well, I’ve got great news for her!

If you get vaccinated against COVID-19 today, you are not in any way a part of an experiment.

23:50 “The first problem is that this brand new technology.”
This is an idea that people find particularly appealing because there is such a large kernel of truth in it. These COVID-19 vaccines are the very first vaccines to be made with mRNA (Messenger RNA) technology. That’s actually really, really exciting stuff, but the big question on everyone’s mind is, “how can we trust something so new?” Or to ask it a different way, “how could we trust a vaccine that was developed in just 9 months?

And to that I typically respond that they weren’t developed in 9 months… they were developed in 1 month.

Wait! That’s a good thing! I know that when they make all the pandemic movies about 2020, inevitably there is going to be a scene like this: All of the scientists are laying around their office in the early hours of the morning after another fruitless night of brainstorming and science experiments, surrounded by empty bags of ‘brain food’ like Red Vines and Doritos (or whatever companies pay them for product placement) and inexplicably still wearing their lab coats, when suddenly one of then sits up and says, “Wait, what if we used MESSENGER RNA TO PROGRAM THE CELLS TO BUILD COVID-19 ANTIGENS?!” Everyone sits up and says “That’s it!”, cue the Science Montage. But the truth is that the mRNA technology has been in development since the 1990’s (read this cool article about it from Stat), and was almost ready for use in vaccines when the pandemic hit.

The vaccine companies received the full genetic sequence of the SARS-CoV-2 virus in January; the first vaccine trial participants got their first doses in March, just 63 days later. The whole rest of the time from then until now was spent in clinical trials to make sure the vaccine was safe and effective.

So when Dr. Gold says this is brand new technology she is trying to scare you; but the real story is, this is brand new technology! Yay! This is the culmination of 30 years of research into how to make better, more effective vaccines… And we have access to it!

24:28 “There’s been a tremendous failure of previous Coronavirus vaccines.”
Again, this is true. You can read a lengthy but really detailed article about the state of SARS and MERS vaccines here; it even touches on the problem of Antibody-Dependent Enhancement that Dr. Gold will get to in a few moments. But there are two salient points that Dr. Gold is missing.

First, the SARS coronavirus has been around since 2002 and has killed 774 people, total. The MERS coronavirus has been around since 2012 and has killed 858 people, total. COVID-19 has been around since late 2019 and has killed 2,220,000 people. Please tell me, if you were in charge of strategically allocating resources, funds, and manpower toward vaccine research, which coronavirus would you focus on? The new vaccines are possible because for the past year the collective will of the world has been focused on overcoming the challenges in making successful coronavirus vaccines.

But second, notice what Dr. Gold just said. At 23:53 she said “mRNA technology has never ever been used before for vaccines,” and at 24:28, just 35 seconds later, she said “There’s been a tremendous failure of previous Coronavirus vaccines.” Previous failures… New technology… Didn’t Dr. Gold just give us hope that this time things will be different? I would have phrased it this way: “Unfortunately we’ve never been successful at making effective vaccines against Coronaviruses. Luckily, the new vaccine- making technology they’ve been working on for 30 years is finally ready!”

24:53 “You may have heard it called the ‘novel coronavirus’, and I never understood that. This coronavirus is 78% identical SARS-CoV-1.”
I mean, it depends on which proteins of the virus you are talking about. The genetic similarity ranges from 76% to 95-100% depending on which proteins we are talking about. I’m just… Not sure why that matters? It’s a coronavirus, so it’s going to be genetically similar to other coronaviruses. What makes it novel is the fact that it causes a novel disease, COVID-19, which has caused the worst pandemic that the world has seen since The Spanish Flu. You are 99.9% similar to the person sitting next to you, but when your friend shows you their new baby you don’t say, “whatever I’ve seen one before.”


25:16 “We’ve never been able to overcome the hurdles to making a vaccine against a Coronavirus.”
Until now! Yay! The vaccines are 95% effective.

Me cheering them on, since I definitely don’t know how to make vaccines.

25:25 “There’s no independently published animal studies.”
Besides the fact that this technology has been studied on animals for 30 years now, this just isn’t the way we conduct clinical trials. Maybe Dr. Gold is hedging here with the term “independently” and wants a particular standard of non-involvement of the vaccine designers with animal studies, but if so that’s special pleading; it’s common for vaccine manufacturers to co-author academic papers with independent labs, and both contribute different information to the paper; after all, they have to send some of the vaccine before it can be tested on the animals at the lab.

So if Dr. Gold is really just saying there needs to be data from animal studies about the safety of these new mRNA vaccines, well great news:

That was just a search for mRNA COVID-19 vaccine mice, and there’s pages and pages of it.

There is substantial, published data on animal studies both for mRNA vaccines in general and for the COVID-19 vaccines specifically. Here’s an AP Fact Check on the topic if you want to learn more.

Dr. Gold goes on to mischaracterize the status of animal studies further, at 25:45 saying “the animals often die in the end, and unless we know that we don’t know if it’s safe to give to humans.” So in 20 seconds we have gone from not having full access to the results of independently published animal studies, which isn’t true, to not knowing whether the animals died. That’s a pretty big jump. (There’s also a ‘Schrödinger’s Cat’ joke in there somewhere but the internet has too many of those as it is).

25:59 Antibody-Dependent Enhancement (ADE)
Immune enhancement is a very real concerned, and one that has been hotly debated within research circles since the beginning of the pandemic, especially in regards to severe COVID-19 cases and the potential role of vaccines. Here’s an article from way back in May 2020 (what is that, like 8 years ago now?) about this exact issue. The specific proteins chosen for the mRNA vaccines were chosen carefully and specifically to avoid this problem, and moreover, this is exactly why we do animal studies and clinical trials.

The Moderna and Pfizer trials were simply huge, with ten times the number of people participating than is typical in a vaccine trial; and no evidence of Antibody-Dependent Enhancement was found. The Nerdy Girls over at Dear Pandemic have a short but great social media update on it from just a couple of weeks ago:

27:21 “Stop Medical Discrimination .Org”
I had to do a double take and rewind (I’m old) the youtube video at this point, because I couldn’t believe what Dr. Gold just said. Do we have some common ground? Health equity, medical discrimination, and American medicine’s history of unequal treatment of people of color, ethnic minorities, and women is a huge issue for me, and my clinic is involved in this work every day. If Dr. Gold has a website devoted to stopping medical discrimination, I will absolutely sign-up, even if I disagree with her about pretty much everything else.

I went to the website. It’s an America’s Frontline Doctor’s Petition to stop ‘forced experimental vaccination’, which is a thing that is not happening (so I guess it worked?).

Justin, could you e-mail them about getting that logo centered over the text? Thanks.

This is pretty gross, to be honest. Discrimination in medicine is a real thing and one of the biggest obstacles both in patients receiving equitable care and in physicians building mutual trust. It is experienced every day by Black Americans, Native Americans, Hispanic and Latino Americans, people who are LGTBQ+, those who struggle with obesity, the disabled, the deaf, the blind, women… Really anybody who isn’t like me; an able-bodied, fairly young, straight white English-speaking male, which we have decided is the standard for “normal” to the great detriment of everyone else (not to mention the peril of our souls). It also applies to those who are discriminated against for work, housing, etc. because of their medical conditions. Personally I’m not ok with America’s Frontline Doctors co-opting either.

Looking ahead, we are going to talk about this later in the video as it relates to Dr. Gold’s complete misunderstanding of racial healthcare disparities (but honestly, I’m glad she’s even mentioning it, even if she gets a lot of the concepts completely backwards). My next blog post will focus heavily on the history of American medicine’s research abuse towards African Americans specifically, and the work Black scientists, physicians, and community leaders have done to ensure the vaccines are safe, and the work they are doing to ensure their communities have equal access to vaccine-mediated protection against the virus. That will be later this week, but in the meantime… You should go read Harriet Washington’s Medical Apartheid, and listen to her 6 minute NPR interview about the vaccines and the problem of how Black Americans can trust new medical technology: Race and the Roots of Vaccine Skepticism.

27:33 “Some of the other things you’ve seen in the news.”
Here Dr. Gold is using “in the news” to mean “on Facebook”, but that’s fine. Kudos to her for skipping over some of these that have been disproven, though I suppose she felt she needed to mention them for anyone in her audience who had seen this misinformation already. For what it’s worth, here’s my analysis of the COVID-19 Vaccine Bell’s Palsy video that came out a few weeks ago.

28:10 – 30:04 “Has anybody heard of potential fertility problems with this vaccine?”
Based on her response I assume that many hands were raised, which isn’t surprising; this has been popular misinformation for months now. I’ve written about it before and since Dr. Gold isn’t actually adding anything new, we’ll move on. The COVID-19 vaccines do not cause female infertility; please feel free to read about it on my Vaccine Q&A post linked above, or any number of fact-checking websites.

30:09 “We simply don’t know.”
“Well you can’t possibly know” is the last redoubt of the lazy skeptic. No scientist would ever claim 100% certainty about what might happen, and the lazy skeptic will take that tiny element of doubt, which is really just a protection against hubris, and expand it until there is enough space for any debunked objection or pet theory they want to store there. There are multiple lines of evidence against the possibility of the new vaccines causing infertility, as I examine carefully in the above link, including many examples of women who have become pregnant after completing one or both doses of the vaccine despite being on birth control to prevent pregnancy. Moreover, there is not a plausible theoretical mechanism by which they would cause infertility. Making irrational, unproven claims and then when they are disproven saying “well we can’t know for sure!” isn’t science; it’s fear-mongering.


Part 3: COVID-19 Vaccines and Racial Healthcare Disparities

I don’t always get to watch these videos all the way through before beginning a response, and especially with the minute-by-minute format I tend to write piecemeal as we go through the video (listen, pause, think, read, think, type, repeat). After being so offended that Dr. Gold would call her anti-vaccine petition website “Stop Medical Discrimination,” I was surprised- and not necessarily unpleasantly surprised- to see her spend so much time on the issue of race and COVID-19 vaccines. In fact, with the exception of her group’s recommendations about getting vaccinated (spoiler: they prohibit or strongly discourage it for almost anyone), the rest of the video focuses on this issue. It’s 11:52 PM on Sunday night, so we won’t make it to the recommendations; if you’ve read this far and you still trust Dr. Gold’s analysis, there is nothing I can say at this point to convince you not to follow her advice; I just hope you’ll follow more reliable medical experts instead, and at least talk about it with your doctor.

I am also anxious to get to my next blog post, which coincidentally or not, is 100% about race and the COVID-19 vaccines, and specifically the question of how Black Americans could trust these vaccines in light of America’s long history of medical research abuse. The main point of that upcoming post is to share resources directly from Black scientists, physicians, researchers, and healthcare professionals; but I’m also going to be taking a look at the history of medical research abuse towards African Americans and at the current pandemic’s disproportional impact on Black communities. In that sense, while the post has nothing to do with Dr. Gold, some portions of it could be seen as a response to her comments in during this section of the video.

For now, I want to say three things to introduce that article, which I hope you’ll join me for later this week, and to conclude this minute-by-minute analysis of as much of Dr. Gold’s hour long talk as I could make it through.

First, I am very, very glad that Dr. Gold is talking about this.
There are a lot of Dr. Gold’s comments I disagree with, and certain points where her analysis and conclusions are essentially backwards. But the fact that she is talking about it is a good thing. The history of medical abuse and research exploitation of Black Americans is one that is too often waved off as one or two isolated examples (Tuskegee) or ignored completely, especially by white doctors. Meanwhile, this history is part of a common experience and shared cultural narrative among Black Americans, and the disconnect between it being known by the group who has experienced it and unknown or unmentioned by the group that perpetuated it can create a tension that is absolutely deadly to the trust the doctor-patient relationship is built on. Dr. Gold is a great example here, in that she acknowledges some part of that history, and in front of a predominantly white audience.

Now, that doesn’t mean I think Dr. Gold’s talk is useful or good; her information on COVID-19 and the vaccines is all wrong, and so her interpretation of important race equity measures in vaccine distribution is interpreted as a racist attack on people of color instead of an attempt to mitigate already existing injustices. She happens to have it exactly backwards; but if she really believes everything she has said in this video, and I think she believes an awful lot of it, then it’s likely she believes her own analysis here, too. Because it isn’t accurate, the net effect of this part of her talk, were it heeded, would be to worsen the already severely inequitable impact of COVID-19 on communities of color, and obviously using that history to that end is incredibly problematic. But at the very least, talking more about that history is a good thing in itself.

Second, Dr. Gold is absolutely underselling the history of harm done to Black Americans by medical science.
Dr. Gold mentions a few specific examples of vaccine reactions that were worse in African Americans, and (I actually can’t remember now if she does or not) mentions a few other examples of racially motivated medical harm. But the true history spans 400 years and is far worse than anything I ever expected, even reading and learning about a few of the most notorious examples in college and medical school. We will look into this in more detail in the upcoming post, but I strongly encourage you to read Harriet Washington’s book, Medical Apartheid.

Third, Dr. Gold is utterly confused on the concept of racial healthcare disparities.
Dr. Gold spends a lot of time arguing that Black communities have not really been more severely effected by the pandemic. Of course, the pandemic is having a more severe impact on Black communities, and Hispanic/Latino communities, compared to their white neighbors, so this feels an awful lot like a magic trick; Dr. Gold is going to make the disparities disappear before our eyes. And the two methods she has chosen? First, to explain away the worse impact of COVID-19 not by race but by economic and social circumstances that place people at disadvantages in terms of health outcomes, and then controlling for all of these, to show that race disappears as a factor. And second, to point to Africa and say that ‘if the virus isn’t killing people at a higher rate in Africa, it must not affect Black people worse.’

It’s really hard to tell if Dr. Gold is in earnest here, but if she is then she really believes that when we say “Black Americans have been hit harder by COVID-19 than white Americans,” we are saying “COVID-19 makes you sicker if you have more melanin”; a position held by exactly zero doctors, epidemiologists, and public health experts.

When we look at the shocking statistics, like the fact that the death rate in any given age range for Black Americans is equivalent to the death rate in White Americans 10 years older, what we are really looking at is the ongoing legacy of food desserts, inequitable access to wealth, intentional destruction of Black communities, mass incarceration, redlining and planned poverty, barriers to medical access, and every other atrocity that makes up 400 years of systemic oppression.

Brookings: Race gaps in COVID-19 deaths are even bigger than they appear

Sure, let’s say for the sake of argument that if you controlled for every social determinant of health, every area in which Black Americans have experienced discrimination and continue to today, the gap in COVID-19 between Black and white Americans would completely disappear (it leaves out discrimination within healthcare, but again… for the sake of argument). Why would that matter? Does a statistical linear regression that eliminates the results of oppression actually alleviate oppression, or just make it more palatable because we can rationalize away healthcare disparities without the discomfort of actually examining root causes?

The fact that there is no genetic factor that makes COVID-19 more dangerous for Black people is exactly the point; it’s the injustices that Black Americans already experience, especially regarding healthcare access, that make the pandemic more dangerous. That is why efforts have to made to ensure Black Americans have equal access to the COVID-19 vaccines, because they are the best tool we have for mitigating the risk of the virus; and it is exactly why Black leaders like the Black Coalition Against COVID-19 are coming together to provide good, reliable information and to dispel COVID-19 myths, so that Black Americans can choose whether or not to get vaccinated with confidence, and so that they will have increased resilience against medical disinformation like Dr. Gold’s video.

I hope you’ll join me to talk more about this later on this week. In the meantime, please check-out the Black Coalition Against COVID-19 and the other resources I’ve linked to above.

Black Coalition Against COVID-19

COVID-19 Vaccine Misinformation (minute-by-minute analysis)

After weeks of COVID-19 misinformation being a secondary or minor issue- to me because we have been so busy actually diagnosing and treating the virus, and to the country in general because election misinformation was much more interesting- I suddenly find myself with more pieces of misinformation to write about than I could possibly make time for. There is this meme that probably needs some attention as people who haven’t complied with mitigation measures since March threaten non-compliance with any future mitigation measures because the mitigation measures they already didn’t comply with didn’t work (because they didn’t comply with them). If I get time I’d love to explore that a little further (and, I should hope, a bit more graciously than I did in that last snarky sentence).

This reminds me of the great Chesterton quote; “Christianity has not been tried and found wanting. It has been found difficult; and left untried.” Could we say the same thing about self-quarantine, shelter in place measures, and especially lockdown efforts? And what then shall we say about wearing masks? “It has been found slightly inconvenient and inexplicably controversial, and tried only begrudgingly and inconsistently?”

There’s also a discussion that we need to have, as a nation, about how this pandemic didn’t go away on November 4th and isn’t going to go away when we have a new president in the White House. This virus is pitilessly apolitical. It doesn’t care about Republicans and Democrats, the electoral college, lawsuits in Pennsylvania, or any of the other big problems facing our democracy (did I just include Republicans and Democrats in the list of problems facing our country? Yes, yes I did). In an election year, and particularly one this contentious, there was never any chance that information and understanding about the pandemic would fail to fall out along party lines. Now that the election is over, is it possible for us to drop our politicized misinformation and as a countrymen find some common ground on which to fight this deadly virus together? Probably not. But it doesn’t mean I can’t rant about it for five or six thousand words.

But I think the most pressing is the video I’ll share a little way below, which was sent to me by a Facebook friend. It’s a short misinformation video about the COVID-19 vaccines that are being developed and, like most misinformation, is an amalgam of half-truths, deliberate misrepresentations, and outright lies. It’s very short and I’ve posted it here in it’s entirety with the hope that you will read the accompanying discussion and not just watch the video.


Will I get the COVID-19 Vaccine?

Let me start with a statement that might be a bit controversial; while I’m obviously strongly leaning that way, and hope I have the decision put before me as soon as possible, I haven’t absolutely decided whether or not I will get the COVID-19 vaccine once it is available. That might sound like heresy coming from a doctor, particularly when we are currently in midst of the worst wave of the deadliest pandemic of our lifetimes.

But let me explain what I mean. While it’s encouraging to hear that the new vaccine from Pfizer is 95% effective against this very, very deadly virus, and while a safe and effective and widely accepted vaccine is the best and quickest route we have to beating the COVID-19 pandemic without even more massive loss of life, I remain at heart and by training a scientist, not a science fan; I default to skepticism of any new discoveries or developments until I have reviewed the evidence for myself. With regards to the COVID-19 vaccines that have been in development over the past year, I am like most physicians cautiously optimistic. Before deciding to have the vaccine administered to myself and my four children, however, I plan to review all the data that I can in order to ensure my choice is as informed and sound as possible, just like I would for any medication, surgery, or any other intervention my doctor recommends (or, for that matter, any treatment or medication that I recommend to my patients).

“But Dr. Webb, this is exactly what anti-vax parents are doing when they refuse vaccines.”

Yeah, except that it isn’t. At least, not generally. You see, when I say I plan to review the data I mean the actual data from the clinical trials and independent studies, not misinformation and propaganda. If you are like me and have the privilege of scientific training that allows you to independently parse the information contained in published clinical trials, you probably have no desire whatsoever to outsource this type of academic work to people who do not have that training and who are approaching the information with blatant and unabashed bias. But if you do not have the background to do that work yourself, you still deserve the same degree of reassurance and comfort before choosing to accept a vaccine or have it given to your children; it is just less likely that you have access to the resources you need. The anti-vaccine movement knows this and it is in this gap- the gap between the confidence you need for such an important decision and the degree of explanation, information, and reassurance that you are generally given– that they do their best (or most effective) work.

Who is to blame? Well, obviously, I am. Your local doctor, your pediatrician, your PCP; we carry the burden not of fighting propaganda, the blame for which rightly rests on those creating and spreading it, but of helping you become resilient against propaganda and misinformation through patient-centered health education.

So I am begging you, if you are at all wary of or uncertain about a COVID-19 vaccine, and if you do not have the technical background or family/community resources you need to review the source data independently, ask your primary care doctor. Maybe even give them a heads up when you schedule an appointment so they can look into it beforehand (they probably already will have). If they are active on social media, ask them if they would be willing to write about it and share it openly. Some primary care physicians, like Dr. Ben Brashear here in Texas, believe so strongly in this type of work that they have devoted a large amount of their time and energy to helping their patients and other readers navigate these issues through their clinic websites and social media pages. I think this is the single most effective way to combat Social Media Misinformation; with a hundred or a thousand or ten thousand doctors and scientists in small towns like mine or Dr. Brashear’s helping patients whom they have already built a trusting doctor-patient relationship with navigate what information is reliable and what isn’t.

And of course, on the off-chance that over the past 6 months of my writing these blog posts you have somehow decided you actually trust me, I’ll plan to write a short post about my decision on the vaccine as soon as I’ve decided, for certain, what to do for myself and my family.

I should also point out, while we are dispensing with preliminaries, that this post is not designed to be an overview of the research and development of the various COVID-19 vaccines. For that I will point you to my hero, Baylor Friendly Neighbor Epidemiologist Dr. Emily Smith.


“The ChAd Vaccine” Video Minute-By-Minute Discussion


0:12 Share this everywhere!

I’ve been doing this sort of misinformation debunking work as a hobby for about 8 months now and I’ve come to recognize some of the language or verbiage that ought to make us extremely suspicious that the information we are about to be given is not necessarily reliable. The speaker hits several right out of the gate:

  • This is a fact.”
    • In my experience, things that are facts don’t need the disclaimer “this is a fact.” Both for people spreading misinformation and those of us fighting it, the goal has to be to lay out such a clear and compelling case for the facts that the rhetorical sledgehammer of “I’m telling you the truth, I wouldn’t lie to you” is as unnecessary as it is hollow. If someone finds this verbiage convincing, it is likely because they are anxious to be convinced; and it should put you on your guard. “Let your ‘Yes’ be ‘Yes,’ and your ‘No,’ ‘No.’ For whatever is more than these is from the evil one.” -Matthew 5:37
  • Share this everywhere.”
    • Similar to the last point, I believe that most people giving reliable, expert advice or guidance will never ask you to “share” something they have written. Why? Because the burden of demonstrating that an issue is so important and pressing that it should be shared broadly lies again with the author, and lies in the substance and veracity of the arguments, not with the mere desire of seeing their assertions disseminated broadly. Nevertheless, I do recognize that “share this now” is a part of our vernacular now and used by almost everyone of a certain generation on back; but I think it is most suspicious as a herald of misinformation when it is accompanied by….
  • They will take this down.”
    • I sure that at some point something I write, either here or just on just on social media, will be taken down or marked as inaccurate; and when that happens I will probably throw a fit like I’ve seen others do. Until then, I will hold onto the sanctimonious belief that only those intending to spread misinformation feel that it is necessary to preface each video, meme, and essay with “this will be removed” or “they don’t want you to know this.” Who, exactly? The expansiveness, complexity, absolute loyalty, and conflicting goals and values of all of these conspiracies you believe are striving to prevent you from seeing some silly video are really beyond belief. The reality is that most scientists don’t mind at all if you watch the Plandemic documentary or Dr. Stella Immanuel’s speech on capitol hill; what matters is that you know going into it that this misinformation has already been disproven, and that you are armed with the understanding and data you need to work through and decode it. This presents an easy enough decision for me; my goal of helping you sort through this misinformation is best served when it is accompanied by the source material, and posting the video alongside the discussion is a no-brainer. But I think it’s a much more difficult decision for Facebook, Youtube, and Twitter, because they have to worry about the viral nature of this misinformation and the real potential for harm, and can’t accompany every repost or upload with a detailed analysis. Allowing lies to circulate without any disclaimer or precautions to protect those that are easily deceived is irresponsible and cruel; it submits to the whims of anyone with any lie to tell or anything to sell. But the very act of censoring or cautioning about misinformation also serves to reinforce the narrative of oppression; the last redoubt for conspiracy theorists is to use the very censure called down onto themselves for the unreliability of their assertions as proof of their veracity. It is a poor sort of fortress to be sure; yet there are far, far too many who see it as the last citadel of truth.
  • And, saddest of all, “Share to all of your Bible groups.”
    • We will talk about the specifics of what misinformation or misrepresentations in this video specifically might appeal to certain streams or factions within Christianity, but for the time being all I can do is grieve, as a follower of Christ, that a video or meme about the pandemic being spread primarily or at a higher velocity within Christian circles is so often a sure sign that it contains little truth and much that is meant to deceive and disrupt efforts of self-sacrifice and self-denial on behalf of our neighbors and community. I have written about how I believe the Church ought to respond to misinformation and why, but it really does feel as though we are behind the World in this area, both in our discernment and in our charity. Lord Jesus, please teach us to be as wise as serpents so that we might be as harmless as doves!

0:26 “Share with… Anybody that doesn’t want aborted fetal tissue fragments put into them.”

This is actually a major claim of the video and the most compelling topic of discussion of the three the speaker introduces, and we will cover it more extensively in just a couple of minutes. For now, let me just say that it is a fact that the COVID-19 vaccine, or any vaccine for that matter, does not contain any aborted fetal tissue fragments! Share with your Bible group, they will take this down!

It also won’t change your DNA, but we’ll get to that too.


0:40 This is the packaging of the AstraZeneca COVID-19 vaccine.

I have not seen the packaging of the AstraZeneca vaccine or any others for COVID-19 and have no reason to believe this individual photoshopped this package (and compelling reasons to believe they are not capable of doing so, as we shall see).


0:59 “It’s called Chad”

ChAdOx1 stands for Chimpanzee derived Adenovirus-vectored vaccine developed by Oxford University. The 1 means it’s the first of multiple Chimpanzee derived Adenovirus-vectored vaccines for COVID-19 that Oxford is working on.

It does not stand for “Chad- whatever that is, zero, or whatever it is- times one.”


1:19 Go to ResearchSquare.com

Research Square is a fine website, just be aware anything you read there is in pre-print; it hasn’t been finalized or peer reviewed yet. That’s the whole point of the website, for people to get feedback before they publish.


1:21 “I want you to learn to do your own research.”

The speaker claims that she wants her viewers to “do their own research” and begins well enough by directing them to Research Square, a reputable website where you can find original sources. But within about 10 seconds she has transformed “doing your own research” into something about as academic and reliable as a Wikipedia binge (or exactly as academic and reliable, since a Wikipedia binge is exactly what it is); googling random words you don’t understand and reading about them, then deciding what you think they mean without any background or context. It’s hard to tell whether she is being intentionally deceptive here, or if she really believes that she has attained a solid grasp of these concepts through the methods she is espousing.

That’s not what research is. In the context she is using it, ‘doing your own research’ at minimum means using the amazing, abundant resources of the internet to learn more about the concepts being discussed, and then using that new knowledge to get yourself over that first hump in the Dunning-Kruger effect and figure out 1. what you need to learn next and 2. what the limits are on how much you can actually learn about this on your own. The good news is, as long as you are humble in your assessment of your own understanding, you can also use that knowledge to 3. verify the reliability of whomever you go to to learn more.

We’ve all done this before, haven’t we? When I wanted to talk to an HVAC specialist about a problem with the air supply plenum in my crawlspace, I studied the anatomy of different HVAC systems, read some discussions on HVAC forums, and watched several videos that addressed similar problems. When this didn’t fully solve my issue, I called the specialist; and I used that research, mixed with a healthy appreciation of my own general ignorance on the topic, to both improve my understanding of his recommendations and to inform my gut decision on whether to trust his expert advice or get a second opinion (for anybody who is curious, he said the squirrels shouldn’t be living in there and he’s coming out to take a look on Monday. Based on my independent research, I’ve decided I believe him… though the squirrels have been waging a fierce misinformation campaign).

I’ve written (though not yet published) about this before; I want my patients to use Google. Really. And then I want them to come and talk with me about what they’ve read so I can help them get further beyond the point they could by themselves. Like I said in the article I’ve written that nobody else has access to:

“Most of all we went to school to become very, very good at parsing information about the human body and its diseases, and when it comes to the research you’ve brought in that is the primary way I can help; by helping you sort out which information is actually going to affect you and which isn’t, which you should worry about and which you shouldn’t, and what the underlying motivations might be for the people that published it. I’ve spent countless hours looking at research and studies and clinical trials and have become very good at determining when a study design is too flawed or data is too skewed to be reliable, when there is a strong bias that makes the data suspect, or when a conclusion is not supported by the evidence as it claims. If you are a scientist or a researcher or have training in those areas you may be able to do the same, maybe just as well or better; but for most people that isn’t the case, and it would be a little silly to trust your doctor when they offer one of the services they are highly trained for, such as looking at your child’s ear and determining if there is a bacterial infection requiring antibiotics, and not trust them when they offer another service they have been highly trained for, such as telling whether the research you’ve brought in about the human body is reliable or not.”


1:28 “Don’t rely on us or anyone else, do it yourself!”

This is so subtle and clever that I just wanted to point it out briefly. “Don’t rely on us or anyone else” when doing your research is an attempt to level the playing field between the different sources you might listen to, and it seems so reasonable on the surface.. Don’t listen to me, or your doctor, or a scientist, or an epidemiologist or researcher, only listen to yourself. The problem is that, at least in the viral version of this video, we have no idea who this lady even is. Telling you not to take her word for it or your doctor’s implies those two sources of information are equally educated, informed, and reliable; this from a lady who just called it the “CHAD Zero Times One Vaccine.”


1:49 “Google every single word on here.”

Again, that’s not “research.” If you need to google some of these words to know what they mean then by all means do so; but that is the pre-research prep work, not the research itself. Thinking you understand a concept because you looked up the definition of a word is unmitigated folly, as she demonstrates in a few moments.


1:58 Recombinant DNA doesn’t mean they are reprogramming your DNA. At all.

The speaker and her assistant begin their “research” by looking up the term “Recombinant DNA” on Wikipedia. Wikipedia is great, and one of my favorite things about it is that most articles are written at a level that most lay people can understand (except the math ones. Yikes). So I think if you want to follow the speaker’s advice here and read that wikipedia article, you should. I’ll wait.

https://en.wikipedia.org/wiki/Recombinant_DNA

But the thing is, she doesn’t actually read it in this video, does she? She only reads the first sentence and then, despite her prior warnings, asks you to take her word on what that sentence means. But listen to the way she says it! The emphasis, the alarm, the righteous anger as she enunciates “molecular cloning” and “genome”! She spits the words out as though it were self-apparent how evil they are, without seeking (or asking you to seek) any additional understanding of what they actually mean. Just one googled word in, and she has entirely abandoned her ‘method’ of research; don’t google every single word in this article that you don’t understand, just take it on her authority that this is bad, bad stuff. She tells you earlier not to be intimidated by scientific terms; but here she actually wants you to be frightened by them.

If you actually read that article, you will quickly realize that the idea she implies here (and stated explicitly earlier on), that recombinant DNA reprograms your genetic code, is actually complete nonsense. In fact, it’s exactly the type of nonsense you would expect if someone’s entire understanding of the science involved was gained through googling random words and reading the first sentence only of wikipedia articles.

The Recombinant DNA got him!

Recombinant DNA describes how the vaccines or medications were developed, not what they do once they are inside of you. Just look at the ‘applications’ section of that same wikipedia article; rDNA technology has been used to develop insulin, accurate testing for HIV, and safe growth hormone for patients with pituitary failure, not to mention interferon therapy for cancer, treatments for cystic fibrosis, and TPA, a life saving treatment for strokes and heart attacks. None of these therapies change your DNA. Saying recombinant DNA therapies change your DNA is like saying that Mashed Potatoes mash you if you eat them. No, the potatoes were mashed during the preparation phase so that they would be delicious for you later on; you don’t get mashed, they do. DNA of fungal or bacterial or animal cells was changed in order to develop these treatments, so that they would be safe and effective for the people who need them.

Since I’m waxing eloquent here, I’ll give one more analogy. It’s like my first and only experience in debate club back during Freshman year of college. The topic was “is preemptive war justified.” The first team to debate, the “for” team, got to define the terms of the debate and chose to argue that preemptive war was justified because nations have the right to defend themselves if they are the victims of a preemptive attack; so preemptive war, “war initiated by a preemptive attack,” was 100% justified… on the part of the nation that was attacked first.

They changed the very definition of the term to suit the argument that was easiest to defend; they were arguing for retaliatory or defensive action instead of preemptive, because it was a much simpler position to defend. And the only problem with that is that words have meanings, Keith!

Sorry, I may still have some baggage to work through there. But that’s exactly what this speaker is doing too; changing the meaning of the term ‘recombinant DNA’ and just hoping you won’t notice or indeed read the very article she has pointed you to herself.

There is one more part of this discussion, and it doesn’t have anything to do with what she’s mentioned here, but intersects with this idea of “reprogramming DNA,” even if I don’t think she has the science background to realize it. Here she’s focused on rDNA, but you’ll also hear discussion about mRNA; messenger RNA, the genetic sequences that organisms use to instruct cellular machinery to build proteins. The two vaccines that have recently shown such promise, from Pfizer and Moderna, both use mRNA technology. Traditional vaccines provoke an immune response, teaching your body to produce it’s own antibodies to fight the infection, by presenting your immune cells with non-dangerous particles of the virus that it can recognize and then build antibodies against. Each of these viral particles has to be produced in a lab and enough of them have to be preserved and injected to ensure some are picked up by your macrophages or dendritic cells and then presented to your lymphocytes (T and B cells) to make sure that you really do develop the ability to mount a robust immune response when you exposed to the virus for real later on.

The mRNA vaccines do the exact same thing, only instead of injecting the deactivated viral proteins directly into your body, they only inject a code for them; a code that teaches the machinery in a few of your own cells to build and release the proteins needed to produce the desired immunity. This outside mRNA hijacks the cellular machinery to produce the proteins needed for immunity without any of the proteins that cause illness; and the rest functions just like a normal vaccine. This is the same naturally occurring ‘technology’ that mRNA viruses use themselves. This is great news for people who want to acquire natural immunity; by mimicking the action that the viruses themselves use, which in turn produces our immune response to them, these vaccines have become the closest you can possibly get to acquiring immunity naturally without actually running the risk of getting sick and infecting others. Instead of getting a deadly mRNA virus from a cough or sneeze, you get a safe mRNA ‘virus’ from a vaccine, and from it your body’s own immune system learns how to kill the deadly virus.

This video below explains these concepts really well, starting at the 1:53 mark.

Again, this mRNA technology doesn’t change your DNA. It just sends a message to some of your cells with a set of instructions, just like any common cold would. Your chromosomes, your genetic code, are unaffected; the vaccine doesn’t even interact with them. If an analogy would help, imagine someone ‘hacked’ your network printer at the office. Normally you are the only person who prints to this printer; you write the document on Word or Notepad (judging you) on your computer and then hit “print,” and the signal goes to the printer, which prints the document. But one day you walk in to find that someone else has been printing things to your network printer. That doesn’t mean that they’ve hacked your computer, it just means they have used your paper and ink (and toner! those monsters).

And what did they choose to print? A detailed set of instructions on how to protect your networked printer from hackers. Big Cybersecurity, at it again.


3:00 “We used direct RNA sequencing to analyse transcript expression from the ChAdOx1 nCoV-19 genome in human MRC-5 and A549 cell lines.”

Here is where we enter what is, I think, the heart of what has drawn most people to this video. I think we can quickly dispense with one piece of false information before entering a more important discussion. The ChAdOx1 nCoV-19 vaccine does not use the MRC-5 cell line. This is an inherent problem with both the ignorance of the speaker (and here I do not mean to be insulting, but merely mean the lack of actual education and experience in the field in which she puts herself forward as an expert) and the deep flaw in her ‘method’ of research. This article is not from the vaccine manufacturer at all; it’s from an independent lab that used these human cell lines to study the vaccine after it was produced. You can find the full text here and read it for yourself. The manufacturers did not use those cell lines. In telling you all about the MRC-5 cell line and warning you that;

One thing [the ChAdOx1 vaccine] definitely has is the lung tissue of a 14-week-old aborted caucasian male fetus.”

Narrator: “It doesn’t.”

the author is stating an absolute untruth based in her own haphazard and unreliable method of trying to find scientific information and uncover medical conspiracies. If her “research” methodology has left her unable to even grasp the basics of who is doing the study and why they are doing the study, or the difference between making a vaccine and studying a vaccine that has already been made, why would you possibly trust her method of research? For that matter, why trust her at all, when she has proven herself so unreliable? Even her assistant, the enigmatic Claire, tries to offer some clarification that the cell line used in the study has been replicated over and over again since the 60’s; that the researchers did not actually abort a child and then collect its cells to study the vaccine (or make the vaccine, as she mistakenly believes); but that attempt is ignored by the main speaker.


What about fetal cell lines in medical research?

Despite the speaker’s severe misunderstanding, and regardless of the tired horror tactic of trying to get you to visualize fetal parts being injected into your children in order to illicit a visceral reaction (there are no aborted fetal parts or fetal cells in vaccines, even the vaccines developed using human cell lines), this is an important question and I think we should spend some time on an actual discussion of it, instead of the sensationalized and inaccurate rage that characterizes its treatment in the video.

I am a pro-life doctor. Like most physicians my views on abortion are nuanced, deeply felt, and strongly based in the lived experiences of my patients. Since this video was designed to spark a visceral reaction among pro-life people in order to make them more susceptible to vaccine misinformation, I think the issue of abortion and fetal cell lines in research warrants discussion on this blog post. I have helped prevent countless abortions, both through providing high quality women’s health services, often to women who otherwise would not have good healthcare access, and by providing compassionate listening, patient-centered care, and judgement free counsel during the most tumultuous times of an unintended pregnancy. There are those that will argue that doctors shouldn’t be pro-life, that my moral opposition to abortion means I can never truly provide unbiased guidance and information to a woman facing this most difficult and painful decision of her life, or that I am somehow unable to respect my patients’ autonomous decision making in this area and help them leave my office more empowered than when they came in. I don’t believe that matches the experience of my patients. I might argue that informed consent, a core principle of medical ethics, is impossible without a robust patient-focused discussion of the medical realities and practical alternatives surrounding the decision to terminate a pregnancy, and that there is reason to believe that these conversations are too often sacrificed or short-circuited once the specter of abortion first arises. It is a debate for another day, to be sure, and with many of the physicians who hold the opposite view I nonetheless share a strong mutual respect, born of proven care for and dedication to our patients, that overrides even our deeply held reservations on this issue. Even on the question of abortion and consent itself, we both believe, based on all of our medical training and the high degree of altruistic concern we bring to our jobs, that we are striving to do what is best for our patients; to help them in the way that is best for them and most consistent with their own stated goals and deepest felt wishes.

Many medications and vaccines use fetal cell lines. The reason is simple; human cells typically work best for studying and developing treatment for human diseases, and fetal cells have unique characteristics that allow cells to achieve, or nearly achieve, cellular immortality; allowing the same cells to be replicated over and over again without any need for additional cell lines to be collected. There is no question that this is a challenging ethical and moral area for pro-life scientists like myself, and strongly pro-life physician and multidisciplinary healthcare organizations, like the Christian Medical and Dental Alliance (CMDA), have discussed and written extensively about it. Here are a few articles CMDA has published, written by conscientious physicians of deep, theologically sound Christian conviction. I hope you will weigh their words and reflections with at least as much gravity as a random person on the internet telling you to “pray big” and share her video with as many “christian-loving” people as possible.

Christian Medical and Dental Alliance:
Am I My Brother’s Keeper?
By Dr.
Amy Givler, MD, FAAFP

Christian Medical and Dental Alliance:
Is Vaccination Complicit with Abortion?
By Dr. Gene Rudd, MD

There are a few salient facts you should know about this area of medicine.

  1. No children are aborted or have been aborted for the purpose of developing medicines or vaccines. The sensationalism that some forces in the anti-vaccine movement are willing to engage in knows no bounds, and it is not uncommon to hear the propaganda that these unborn babies were actually aborted for the purpose of being used in medical research. This is simply wrong. The few unborn children whose cells (or accurately, copies of copies of their cells) are regularly used in medical research and development were likely aborted for the same reasons that most abortions occur; the unbelievably difficult balance of perceived goods and anticipated challenges faced by a woman who had not intended to become pregnant. These mostly occurred in the 60’s and 70’s, and cell lines (copies of cells) derived from those same aborted fetuses have continued to be used ever since without the ‘need’ to derive new cell lines from abortions occurring today. For instance, HEK 293, the actual cell line used in the development of the ChAdOx1 vaccine, was derived from an abortion in The Netherlands in 1973; we simply do not know the story of the woman who chose to have this abortion, or the reasons behind her choice.
  2. There are no fetal cells in vaccines; not even in vaccines developed using fetal cell lines. Vaccines are not a ‘mix’ of fetal cells and viral particles, not by any stretch of the imagination. When fetal cell lines are used to grow viruses that infect humans in the vaccine development process, it is distant to the final product of the vaccine, which has also been through multiple rounds of purification. The human cell lines are used to grow the virus and deactivate it; they are not included in the actual material injected through a syringe to produce an immune response in our bodies.
  3. Not all vaccines use human cell lines. There are vaccines for almost every vaccine preventable illness that are designed using methods that even the most rigorous pro-life groups consider ethical. When the anti-vaccine movement tries to convince you that all vaccines are suspect from a pro-life perspective, they are rather co-opting a pro-life position for their own aims rather than being a legitimate part of the pro-life movement.

Like the CMDA doctors above and most pro-life physicians and scientists, and even the Vatican, I believe that using vaccines and medications not developed using fetal cell lines from aborted human beings is strongly preferable whenever possible, and that this is an area where continued economic and moral pressure can encourage pharmaceutical companies and research institutes to pursue alternative means of developing novel treatments to human disease. However, the principles of whole-life pro-life ethics also dictate that a treatment or preventative measure developed in part through material derived from a past harm through abortion, with no potential to cause further harm in this same way but massive potential to prevent loss of life (including unborn human life) is still, clearly, a moral good; a position even Popes have affirmed. In saving the lives of a great many people from a single death that would not have been prevented regardless, we derive the greatest possible moral good from what was an undeniably tragic situation for all involved.

For pro-life persons, accepting a vaccine that was developed from fetal cells collected 50 or 60 years ago makes them neither complicit with nor promoting of a depreciation of human life. But seeking treatments developed using alternative means may send a message to pharmaceutical companies that these issues are indeed dear to their hearts and that their collective will is that these methods in research would become a thing of the past.

And the great news for staunchly Pro-Life people is that not even all effective COVID-19 vaccines use fetal cell lines. Neither the Moderna vaccine nor the Pfizer vaccine, the two that have been recently publicized as 95% effective against COVID-19, used fetal cell lines in development or production. The question of fetal cell lines in medical research and development is an important one; but it is not likely to be an issue when getting vaccinated for COVID-19, assuming you have some degree of freedom in which vaccine you choose.


4:23 “This is what they want… They KNOW this vaccine is going to hurt people or kill people so badly.”

A few things here.

  1. If there is a way to kill people not so badly, please let me know. We could be on the brink of a medical breakthrough here.
  2. Who is “they” anyway?

She jumps around so much in this video that the viewer is left to assume, just like with the MRC-5 discussion, that this last bit is screenshot from the original papers from the vaccine manufacturer; that the people making the vaccine have, in their published study, asked the universe at large to supply them with some sort of computer program or something to help them sort through all the people they intend to maim or kill. We’ve talked before how conspiracy theories rely on this weird paradox where shadowy conspirators are both incredibly clever, subtle, and nigh-invulnerable but also so clumsy as to announce their real plans in such a way that some random person on the internet can piece it all together with a 5 minute video. Pfizer or Moderna publishing “please help us, our excel spreadsheets aren’t robust enough to keep track of all the victims we are after” at the bottom of their research would certainly fall under this phenomenon.

But this isn’t from the vaccine manufacturers. It’s from the Medicines and Healthcare products Regulatory Agency (MHRA), the British counterpart of the FDA. And it isn’t from a research paper, it’s from their contracts division, announcing the technology services they are hoping to contract with as they anticipate the release of these vaccines.

Why would the MHRA or FDA want to track possible adverse reactions to a new vaccine?
Because it’s literally their job.

And why would they anticipate a “high volume” of reported adverse reactions?
Because we are in the middle of a highly politicized, deeply contentious global pandemic; billions of people are going to get these vaccines, and some of them are going to have very mixed feelings about it. Adverse reactions to vaccines range from the common but mild to the serious and extremely rare, but reported or perceived reactions are all over the place. I saw a patient yesterday who believed that his flu shot had caused him to feel fatigued and sore the next day (it had), and also to have six days of diarrhea and loss of taste and smell two weeks later (it hadn’t). He tested positive for COVID-19, the true source of his symptoms. I’ve also had patients who believed their flu shot gave them COVID-19, which is utterly impossible.

Vaccines feel scary; they are sciency and mysterious and they are going into your body, and you are taking someone’s word for it that they are safe and a wise decision. I get that. A new vaccine is even scarier, and a new vaccine for a virus that is deadly, has changed our entire lives over the past year, and is surrounded by a thick haze of misinformation and conspiracy theories is even scarier. Some of the folks getting that vaccine are going to do so, probably to keep those around them safe, only after warring within themselves over it (even I told you I’ve still got some research to do before I’m fully satisfied with the decision). For some of those folks, anything medical that happens to them in the next few months might potentially feel like the negative fallout of that one difficult decision. The point of the MHRA using an AI tool to augment their ability to analyze that data is so that they don’t miss any real adverse reactions hidden in all of that noise; to make sure that if the vaccine is dangerous after all, despite the safety demonstrated in clinical trials, they discover it as quickly as possible. Again, because that’s their job. This is evidence that the people tasked with making sure the vaccines are safe really do take that role seriously; not evidence that someone is planning to hurt you and wasn’t sneaky enough in hiding their intentions.


5:01 “I don’t know how you do it, I’m not technical.”

After watching the same 5 minutes of these folks pointing a shaky phone camera at their computer screen and pulling up various image preview programs and web browsers over and over again while writing this blog post, I can now verify that this is the single most true and reliable statement in the entire video.

It looks like I’m just being cheeky at this point, so I guess it’s time to stop there.