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 bdiy 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.


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


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.

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

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

I have seen this video of Dr. Simone Gold, Dr. Stella Immanuel, and Dr. Dan Erickson, and other physicians in almost every format over the past 24 hours; from a 45 minute long version to just Dr. Immanuel’s comments. My favorite presentation of it, if I’m allowed to pick a favorite, is the headline that I saw first which read, “American Doctors Address COVID 19 Misinformation with SCOTUS Press Conference.” I know it’s the oldest tactic in the book, but something about people spreading misinformation by claiming they are fighting misinformation still really gets to me. I understand this video was viewed over 14 million times before youtube and social media sites began to take it down, and I understand why. The group, America’s Frontline Physicians, present themselves in patriotic themed lab coats (I did not know that was a thing) in front of the US Capitol (or whatever building that is; I was homeschooled), and tell Americans what we have all so desperately wanted to hear for months; there’s nothing to be worried about, your lives can go back to normal now.

Several of these physicians we are already familiar with. Dr. Dan Erickson’s interview with local news stations was perhaps the biggest COVID-19 misinformation viral video until Plandemic came along (a week later), and Dr. Simone Gold has gone viral multiple times; I addressed her “COVID-19 as a Mass Casualty Event” letter on the blog back in May. Though these doctors don’t know me from Adam, to me they are starting to feel like old friends; or at least old frenemies. They are becoming more sophisticated in the posturing they take around misinformation (that sounded ominous; “they are becoming more sophisticated”, like they were killer robots from SkyNet); including in their talk the idea that they are being ‘silenced’ even though tens of millions of Americans have heard their dissenting minority opinions, claiming to speak for ‘thousands of doctors’ (this is probably an accurate number; there are about 1.1 million doctors in the US), and painting a convincing picture of themselves as the front-line doctors ‘actually diagnosing and treating’ COVID-19 and the people ‘silencing’ (read: disagreeing with) them as shadowy powers-that-be, as opposed to just being the vast majority of conscientious front-line doctors who simply hold to higher standards of evidence and have less tolerance for the invasion of political concerns into our care of patients. All of this is lent some credence by the fact that this video is being censored on Youtube and Facebook, of course; but considering the views they share really are dangerous, I have to admit that I don’t know whether censoring the video is the right call or not; I’m glad it’s not my decision to make. My approach has been to analyse and discuss, and I’m thankful for those who have provided me with the transcript and alternative links to the video for me to try to do that.

Since I worked from 8-5 today, including a morning spent in our outdoor tent clinic diagnosing, treating, and counseling patients with COVID-19, and a motorcycle drive in a torrential downpour (it said 10% chance of precipitation!), I’m about 18 hours behind on responding to this video. In interest of making this analysis available to those who have asked for it more quickly, I’m going to take it one doctor at a time, starting with a response to Dr. Stella Immanuel’s comments. The full transcript is below, up to the Q&A which I won’t spend time addressing. My comments are in blue and will be added as I go.

TL;DR: Posting now, editing and adding to later. Reserve the right to wake up at 3 AM and fix spelling erros.

Congressman Norman: (00:00)
… I’ll turn it over.

I have no idea who Congressman Norman is, but it has a very sinister ‘Spider-Man villian’ ring to it, doesn’t it?

Dr. Simone Gold

Dr. Simone Gold: (00:01)
Thank you. Thank you so much congressmen. So we’re here because we feel as though the American people have not heard from all the expertise that’s out there all across our country. We do have some experts speaking, but there’s lots and lots of experts across the country. So some of us decided to get together. We’re America’s Frontline Doctors. We’re here only to help American patients and the American nation heal. We have a lot of information to share. Americans are riveted and captured by fear at the moment. We are not held down by the virus as much as we’re being held down by the spider web of fear. That spiderweb is all around us and it’s constricting us and it’s draining the lifeblood of the American people, American society, and American economy.

America’s Frontline Doctors seems like a new organization, but for COVID-19 Viral Video enthusiasts like myself, seeing them all together in this video feels like the first time we saw all of the The Avengers together in The Avengers after 4 years of build-up. The group’s logo is a caduceus overlaid with an American flag; a perfectly fine image, I suppose, but taken with their political aims it sends a clear message; “we are the only doctors that true American patriots can trust.” Later, when these physicians make claims that other doctors have not been using hydroxychloroquine, have been encouraging people to wear masks, or have been advising caution and social distancing because of political motivations, please remember exactly who has overtly politicized their medical calling and emblazoned it on their lab coats. You know what my lab coat has it on? Germs (that’s what they all have, which is why I don’t wear one).

I think Dr. Gold’s discussion of the fear capturing the American people here is very interesting. Certainly there are many responses to the deadly viral pandemic that America is facing; fear, anxiety, bravado, calloused indifference, defiance. I’ve had all of those responses myself, and that was just this morning. I have seen many people suffer from anxiety about the virus, for the sake of themselves and their loved ones, and have offered a listening ear and counseling (and, when appropriate, anxiety medication); I have also seen people who consider COVID-19 to be a political tool or a hoax and have shown brazen disregard of the very real danger posed by the virus, and a great many of them are going to watch and share this video. There is something fairly calloused and icky about sharing a message that ‘you don’t have to be afraid anymore’ to people you already know aren’t taking a dangerous thing seriously. Nevertheless, I’ve actually repeated Dr. Gold’s main point here, “I don’t want you to be afraid,” at least 100 times in the past week; probably far more. When I counsel patients who likely have COVID-19, or whose loved ones do, I almost always tell them that I don’t want them to be afraid. I also tell them about social distancing and counsel them on isolation precautions, and talk to them about getting in touch with their close contacts to encourage them to quarantine, and I talk with them about reasons they would return to my clinic or go to the ER or even call 911 if their symptoms worsen. Because my desire for them not to be afraid isn’t because there isn’t anything anything to be afraid of, like Dr. Gold claims, but because because fear leads to anger and anger leads to hate, and hate leads to suffering… Because fear is the mind killer, the little-death that brings total obliteration… Because with great power comes great (no wait that isn’t one, sorry)… But really because God has not given us a spirit of fear, and I believe that my patients will thrive best and be most free from fear when they have a healthy respect and understanding of the virus and how to protect others and respond to complications based on the best, most reliable information possible.

Dr. Simone Gold: (00:53)
This does not make sense. COVID-19 is a virus that exists in essentially two phases. There’s the early phase disease, and there’s the late phase disease. In the early phase either before you get the virus or early, when you’ve gotten the virus, if you’ve gotten the virus, there’s treatment. That’s what we’re here to tell you. We’re going to talk about that this afternoon. You can find it on America’s Frontline Doctors, there’s many other sites that are streaming it live on Facebook. But we implore you to hear this because this message has been silenced. There are many thousands of physicians who have been silenced for telling the American people the good news about the situation, that we can manage the virus carefully and intelligently, but we cannot live with this spider web of fear that’s constricting our country.

Dr. Simone Gold: (01:45)
So we’re going to hear now from various positions. Some are going to talk to you about what the lockdown has done to young, to older, to businesses, to the economy, and how we can get ourselves out of the cycle of fear. Dr. Hamilton.

Dr. Bob Hamilton

Dr. Bob Hamilton: (02:03)
My name is Dr. Bob Hamilton. I’m a pediatrician from Santa Monica, California. I’ve been in private practice there for 36 years. And today I have good news for you. The good news is the children as a general rule are taking this virus very, very well. Few are getting infected. Those who are getting infected are being hospitalized in low numbers. And fortunately the mortality rate of children is about one fifth of 1%. So kids are tolerating the infection very frequently, but are actually asymptomatic.

And thank God for that. As a father of 4 young children, I cannot even imagine the anxiety, fear, and paranoia I would experience if we were living through a pandemic like the Spanish Flu, which disproportionately killed young children. I cannot imagine the pandemonium, the incredible amounts of fear, and even the difficulty in staffing clinics and hospitals if exposure to the virus put our children‘s lives at great risk instead of just our own. Though Dr. Stella Immanuel below discusses the panic that her patients commonly present with when they believe they may have COVID-19, I’ve only see this a few times; many patients need reassurance and education, but only a handful have been truly on the verge of a panic attack. But I have seen many, many people very concerned about their children and grandchildren. In fact, when I inform patients that they have been diagnosed with COVID-19, they usually ask “what about my children?” before they ask any other question.

The truth is we don’t know the mortality rate among children, for a lot of the same reasons that it’s so hard to lock-down a true infection fatality rate in general; imperfect testing, asymptomatic cases, minimally symptomatic cases that are never tested, and still being fairly early in the course of the pandemic and not having all of the data we need. But we all agree it’s smaller than for older patients, and Dr. Hamilton’s estimate of 0.2% is within the commonly accepted range based on the data we do have. I would point out that 0.2% is still a very alarming mortality rate for a virus that is as infectious as COVID-19; but a lot of us hope the rate is actually even lower and that children tend to be asymptomatic or minimally symptomatic at a high enough rate that we are simply missing most cases. We hope, but we don’t know. So while I can counsel the patients who anxiously ask me if their children are going to be ok (which would be the very first question on my mind as well) that they are at less risk from COVID-19 than any other age group, I cannot promise them that their children will be unaffected or free from risk, and I still counsel them on what to watch for.

Dr. Bob Hamilton: (02:38)
I also want to say that children are not the drivers of this pandemic. People were worried about, initially, if children were going to actually be the ones to push the infection along. The very opposite is happening. Kids are tolerating it very well, they’re not passing it on to their parents, they’re not passing it onto their teachers. Dr. Mark Woolhouse from Scotland, who is a pediatric infectious disease specialist and epidemiologist said the following. He said, “There has not been one documented case of COVID being transferred from a student to a teacher in the world.” In the world.

I think here Dr. Hamilton is straying into a fairly disingenuous way of looking at these statistics. One of the first and most widely followed mitigation steps early in the pandemic was to transition schools to online learning. More than closing non-essential businesses, more than observing social distancing, more than wearing masks once sufficient evidence to support mask-wearing was amassed, children were compliant with not being in school at very high rates because schools were, physically, closed. I will accept that children have not been the driver of the pandemic; they are also one of the groups that has been kept at home most successfully during it. Saying children have not driven the pandemic is not the same as saying they would not have or might not if these mitigation measures were not followed. The question of whether or not children can or will drive the pandemic once schools reopen in person is nuanced and difficult; I’ll try to address it in the next paragraph and in greater detail in a later article. But it’s important that we don’t fall into the trap of evaluating the course the pandemic has taken so far without taking into account the effects of the precautions and mitigation measures we have taken in response to it.

Dr. Bob Hamilton: (03:19)
I think that is important that all of us who are here today realize that our kids are not really the ones who are driving the infection. It is being driven by older individuals. And yes, we can send the kids back to school I think without fear. And this is the big issue right now, as Congressman Norman alluded to, this is the really important thing we need to do. We need to normalize the lives of our children. How do we do that? We do that by getting them back in the classroom. And the good news is they’re not driving this infection at all. Yes, we can use security measures. Yes, we can be careful. I’m all for that. We all are. But I think the important thing is we need to not act out of fear. We need to act out of science. We need to do it. We need to get it done.

Again, just because children in school have not driven transmission so far, because they have not been in school, doesn’t mean that it isn’t a risk. I don’t know whether or not we should reopen schools normally in a few weeks. There are lots of reasons I haven’t been able to come to anything like a firm conclusion about it. The data is complicated, and it’s such an important question that it really does require a degree of thorough research and critical thinking that I have not been able to give to it yet. Part of that is my own privilege; my wife and I homeschool our four children (and I include “and I” very generously), so it’s a question that doesn’t personally affect us. Homeschooling has always involved some degree of privilege, even though it is also challenging and requires sacrifice, but that’s never been quite so obvious to me as it is now in the midst of this pandemic, when this one big question mark seems to be looming over nearly every family we know but our own. But even though it doesn’t directly affect our own children, there are many teachers and school aged children that we deeply care about (and tons that we sort of care about or middling care about), and the question has been heavy on my mind, especially as more and more close friends have asked me to research and write about it.

All of that to say, I don’t have an answer today; I hope to write about it soon, but I can’t promise I’ll have an answer then either. For now I’ll say this; I think the burden of proof has to be on the side of proving it’s safe, not on the side of proving it’s not safe. I need to review the studies on transmission and shedding in children, but the claim I’ve seen that children are very unlikely to transmit the virus seems very counter-intuitive. Transmitting respiratory viruses is what children do. I’ve got four of these booger goblins at home; the little one gives kisses by putting his entire mouth around your nose, and the 2nd youngest “whispers” to you by blowing spit into your ear and your eyeball. One of the questions we always ask someone with a cold or flu, even pre-COVID-19, is whether they have been around anyone sick. If the answer is “well I have kids” or “well I work in a school” my response is, “say no more.” If there’s one thing we’ve learned about COVID-19, it’s that it’s different. Maybe kids really don’t shed it, maybe they really don’t spread it to each other or to adults; maybe we can reopen schools with sufficient distancing guidelines that it will not endanger the lives of children or or adolescents or their caregivers, teachers, or families. If that’s the case, that’s wonderful; but it has to be very, very clearly demonstrated by real scientific evidence. It isn’t something we can risk on the type or quality of “evidence” that some of the members of America’s Frontline Doctors seem to find sufficient. We’ll try to look at as much of that evidence as we can in an upcoming post.

Dr. Bob Hamilton: (04:07)
Finally, the barrier, and I hate to say this, but the barrier to getting our kids back in school is not going to be the science, it’s going to be the national unions, the teachers union, the National Education Association, other groups who are going to demand money. And listen, I think that it’s fine to give people money for PPE and different things in the classroom. But some of their demands are really ridiculous. They’re talking about, where I’m from in California, the UTLA, which is United Teachers Union of Los Angeles, is demanding that we defund the police. What does that have to do with education? They’re demanding that they stop or they shut all private charter schools, privately funded charter schools. These are the schools that are actually getting the kids educated.

This gets too deep into politics for me. Look at the various teachers unions’ demands (if they have demands) in your area for yourself and see if you think what they are asking for is reasonable. Better still, talk to teachers you know and ask for their opinion on reopening schools, the same way that you would (hopefully) ask me or another physician you know about our views on wearing masks or other medical issues related to the pandemic. I know some teachers, and I know that their greatest desire (besides something called a “smart board”) is to be back in the classroom educating and pouring life into your children. They want the schools to reopen, but they want to know the safest and wisest way for it to happen, because too much of their job already deals with childhood suffering, and seeing anything like an abnormally high number of their students (your children) die from COVID-19 because we re-opened schools in the midst of a surge of cases would break them. No profession is perfect (something I’m hoping to write about soon too, but in the meantime you should go read Harriet Washington’s Medical Apartheid for yourself), but if you don’t think doctors in general want you to be well and thrive, and you don’t think teachers want your children to grown and learn, I’ve got some questions about who you do trust.

Dr. Bob Hamilton: (04:59)
So clearly there are going to be barriers. The barriers will not be science. There will not be barriers for the sake of the children. That’s going to be for the sake of the adults, the teachers, and everybody else, and for the union. So that’s where we need to focus our efforts and fight back. So thank you all for being here and let’s get our kids back in school.

Leave out that there really are some scientific barriers to knowing whether or not fully reopening schools is actually going to be safe for the children, which is probably the single biggest concern among teachers anyway; there’s still something very calloused about calling out teachers for not wanting to re-open schools because of concerns about their own safety.

Dr. Stella Immanuel

Dr. Stella Immanuel: (05:27)
Hello, I’m Dr. Stella Immanuel. I’m a primary care physician in Houston, Texas. I actually went to medical school in West Africa, Nigeria, where I took care of malaria patients, treated them with hydroxychloroquine and stuff like that. So I’m actually used to these medications.

I’ve learned an awful lot from African physicians over the years, though I’ve never been to Nigeria and have not had the privilege to travel to West Africa since before medical school. I do not know the arc of Dr. Immanuel’s career, how long she practiced in Nigeria and how long she has now practiced in the US (I am told she used to live in the same city where I did undergrad). On my most recent short term trips to volunteer in hospitals in South Sudan and Uganda, I went in a teaching role; and while I did have some things to contribute, there is no question that I gained from doctors there more knowledge and insight than I was able to give, which is what I fully expected would happen. And nowhere was this dynamic more clear than in treating patients with “tropical diseases” like yellow fever and malaria. Diagnostic tests, medications, and clinical pictures that I had encountered primarily in textbooks were bread and butter medicine for the physicians I worked with, and I’m sure I must have seemed fairly slow on the uptake, trying to figure out the right chloroquine dose for pediatric malaria patients or recognize the differences in the clinical picture between malaria and dengue fever. While I’ve now also used these medications for malaria, in addition to prescribing them for lupus here in the US, I would completely concede more extensive experience with antimalarial agents to a West African trained doctor like Dr. Immanuel. What I cannot honestly concede is more extensive experience diagnosing and treating COVID-19.

Dr. Stella Immanuel:
I’m here because I have personally treated over 350 patients with COVID. Patients that have diabetes, patients that have high blood pressure, patients that have asthma, old people … I think my oldest patient is 92 … 87 year olds. And the result has been the same. I put them on hydroxychloroquine, I put them on zinc, I put them on Zithromax, and they’re all well.

The best way to study a medication’s efficacy is a double-blinded, randomized, controlled trial. There are studies that have been done and are being done on hydroxychloroquine for COVID-19 that are designed this way, and if done carefully they will provide the absolute highest quality data we will have on this medication. So far the ones we have do not show benefit. It’s worth pointing out here that one large, well-designed study is of much greater value than many small or poorly designed studies, and of infinitely greater value than any one or a few clinicians’ anecdotal experiences. But in a pandemic I do believe in an all-hands-on-deck approach to both clinical treatment and research, and I appreciate all of the doctors for whom research is not a usual interest or activity taking the time and energy to bring their results forward.

But we would not be wise to digest these results without understanding their significance. When Dr. Immanuel says she has treated 350 patients for COVID-19, that feels like a fairly large number; especially compared to the dozen that Dr. Bartlett had treated to support his claims for budesonide or the 50 that Dr. Procter had treated in a recent viral facebook post. But we still need more information, like how her patient population’s demographics compare to the population in general, which she only hints at, telling us the age of her oldest patient but not providing a median age or other demographics factors or data on comorbidities or high-risk conditions. Depending on their risk factors and their ages, zero deaths out of 350 might be exactly what we would expect. Even if Dr. Immanuel’s population perfectly represented the general population (and we have good reasons to suspect this is not the case, as we will discuss below), where we believe the infection fatality rate is somewhere in the still-very dangerous- range of 0.4% to 1.3%, this would only be 1-4 fewer deaths than expected; wonderful, well worth celebrating, but not miraculous, and certainly not proof of a cure. But aside from the simple numbers, there are bigger issues we need to be honest about here.

Dr. Stella Immanuel: (06:12)
For the past few months, after taking care of over 350 patients, we’ve not lost one. Not a diabetic, not a somebody with high blood pressure, not somebody who asthma, not an old person. We’ve not lost one patient.

As I’ve done for every doctor making claims of perfect efficacy for unproven medications over the past few months, I’d like to look at Dr. Immanuel’s claims in the context of her treatment setting; namely, outpatient Family Medicine in Houston, Texas. Here is the graph of positive cases in Houston.

If this looks familiar to my fellow Wacoans, maybe it’s because it looks almost identical to the trend in cases in Waco, and really in most places around Texas. Here is our trend from April to July from the health department’s tracker at covidwaco.com (based on positive test results).

You’ll note these charts are not to the same scale; Waco does not (yet) have a population of 2.3 million people. But there are only so many patients a doctor can see in a day, and both Waco and Houston have had plenty of COVID-19 cases, and people being evaluated for possible cases, to keep more than one doctor very busy, and it’s pretty hard for me to imagine that Dr. Immanuel has seen many more patients for evaluation of COVID-19 symptoms than I have over the past couple of months. But if we look at these trends it strongly implies that the vast majority of her patients who actually had COVID-19 would have been in the past 6 weeks, just like mine have been; before that the infection rates in Houston and in Waco were too low for either of us to have extensive experience with patients who actually had the virus, regardless of how many people we were evaluating and testing (important work still, since none of us knew when our surge would start). She doesn’t tell us how many of her 350+ patients were in March, April, and May and how many have been since mid-June, just that she has treated that many patients with hydroxychloroquine over the past several months. If we assume that the majority of these patients have been in the last 42 (great number) days since cases began to climb in Houston, it means that a lot of her patients are not out of the woods yet. There is a lag time from the development of early symptoms of COVID-19 to the development of severe complications, and a further lag time from this to death, while patients fight for their lives in the hospital and doctors and nurses do everything in their power to help them. Finding an exact number is difficult because there are so many factors and so many different ways that people are affected by the virus; but the total lag from onset of symptoms to death seems to be around 18 days. Even this is likely an underestimate, however, since any such data would exclude people experiencing a prolonged battle with the virus who are still fighting it at the time the data is collected, but ultimately pass away from it later. This gives us a mere 24 days during which we can say Dr. Immanuel has had time to see a significant number of patients with COVID-19 and feel confident in saying that those patients have fully recovered and are no longer in danger.

I am playing a bit fast and loose with these numbers here, because I don’t actually think Dr. Immanuel means that the majority of her 350 “COVID patients” have been within the past 6 weeks. The point is this; when doctors claim to have been treating COVID-19 a certain way for months, you need to look and see how many months there have actually been COVID patients in their area. Because if the length of time they have been ‘treating COVID’ successfully and the length of time that SARS-CoV-2 has been endemic in their region don’t line up, we have to ask an important question that runs deeper even than the demographics and risk factors of their patients; did the patients they treated even have COVID-19 at all?

You see, over and over when we have heard from physicians like Dr. Irene Lozano and Dr. Brian Procter that they have a 100% cure rate with hydroxychloroquine or another regimen, it turns out that their definition of ‘having COVID-19’ is extremely liberal. One admits to treating patients with minimal symptoms and questionable exposures; the other says he doesn’t even believe in testing for COVID-19. This is the most basic concept of epidemiology imaginable, but you can’t die from a disease you don’t have. If a doctor says they have successfully treated a condition x number of times, but their diagnosis of the condition doesn’t conform to accepted standards of certainty or rely on any evidence other than a hunch or their desire or ideological commitment to ‘diagnose’ and treat the condition, their results are less than useless; they don’t even count as anecdotal evidence.

I don’t know if this is the case for Dr. Immanuel; she doesn’t say that she doesn’t believe in testing, she doesn’t tell us what test her clinic uses or its sensitivity and specificity, or how many of her hydroxychloroquine patients were treated during Houston’s pre-surge months, or if she uses the accepted clinical diagnostic criteria in lieu of a positive test. I cannot say definitively that Dr. Immanuel has done what so many doctors in these videos have done and artificially inflated her COVID-19 patient series by treating people who did not meet any accepted diagnostic criteria but were merely worried they might have the virus. But this is absolutely key to understanding the significance of her success rates, and I do think she gives us a few important clues in that direction.

Dr. Stella Immanuel:
And on top of that, I’ve put myself, my staff, and many doctors that I know on hydroxychloroquine for prevention, because by the very mechanism of action, it works early and as a prophylaxis. We see patients, 10 to 15 COVID patients, everyday. We give them breathing treatments. We only wear surgical mask. None of us has gotten sick. It works.

This is clue number one, and it’s a big one. I sometimes use a phrase I’m pretty sure I’ve coined; “we aren’t keeping the secret medicines for doctors hidden in the back.” I say this, when I think it’s appropriate to the patient, to help dispel the idea that I am holding out some sort of secret treatment that I only prescribe to other doctors and their families, which is something that my patients sometimes believe (and that some of them have very good historical reasons for believing). A compassionate, conscientious physician is going to treat your condition the same whether you have an MD or PhD or have very little education, whether you are rich or poor, and even whether or not they like you or you are mean to them; we don’t keep secret medicines in the back that you don’t unless you are ‘in the club.’ And because I believe that Dr. Immanuel is a compassionate physician, I don’t believe that she would be willing to give herself, her staff, and other doctors and medical personnel hydroxychloroquine as prophylaxis if she were unwilling to do the same for others. If she really believes it works in this clinical setting, it would be consistent of her to offer hydroxychloroquine for patients who have been around others with COVID-19, or thought they might have been, or who work in other high risk environments like nursing homes, food service, and grocery stores. And because she has more extensive experience with hydroxychloroquine for malaria treatment and prophylaxis than most US trained physicians, it would be reasonable to expect her to be somewhat more liberal in prescribing it for this purpose without the same degree of anxiety a doctor might feel who has only used it for lupus.

In claiming that she has successfully treated over 350 patients with COVID-19 with hydroxychloroquine, is Dr. Immanuel including the patients she has treated merely for prophylaxis, who have not been diagnosed with an infection at all? I don’t know, but considering the national stage and the passion she feels on this issue, I would feel a great degree of temptation to include those patients and bolster my treatment numbers, and if I wasn’t including them I would want to be explicit on that point.

Dr. Stella Immanuel: (06:46)
So right now, I came here to Washington DC to say, America, nobody needs to die. The study that made me start using hydroxychloroquine was a study that they did under the NIH in 2005 that say it works. Recently, I was doing some research about a patient that had hiccups and I found out that they even did a recent study in the NIH, which is our National Institute … that is the National … NIH, what? National Institute of Health. They actually had a study and go look it up. Type hiccups and COVID, you will see it. They treated a patient that had hiccups with hydroxychloroquine and it proved that hiccups is a symptom of COVID. So if the NIH knows that treating the patient would hydroxychloroquine proves that hiccup is a symptom of COVID, then they definitely know the hydroxychloroquine works.

Dr. Immanuel is referring to a case report from April of one patient, a 62 year old man who presented to the ER with hiccups; he was found to have diffuse groundglass opacities on CT scan of his lungs and tested positive for COVID-19. The case study mentions that he was treated with hydroxychloroquine exactly once (twice if you count the abstract); it was standard treatment at the time this man was admitted, as it was in most places around the country before more evidence emerged that it wasn’t efficacious. The study draws absolutely no conclusions that his COVID-19 was cured by hydroxychloroquine, but rather was published to emphasize that “physicians should keep COVID-19 infection on their differential as more cases are discovered through atypical presentations.” The idea that this case study somehow proves that the NIH “knows the hydroxychloroquine works” is a complete non-sequitur and betrays either intentional or accidental misunderstanding of the case study. Also, I love it when people google things and then post viral videos telling other people to google those things; it creates fascinating Google Trends graphs:

Dr. Stella Immanuel: (07:42)
I’m upset. Why I’m upset is that I see people that cannot breathe. I see parents walk in, I see diabetic sit in my office knowing that this is a death sentence and they can’t breathe. And I hug them and I tell them, “It’s going to be okay. You’re going to live.” And we treat them and they leave. None has died.

This is clue number two. You see, Dr. Immanuel has fallen into the trap that so many other doctors whose claims we have looked at on this site have fallen into; they are actually treating the virus as though it were even more dangerous than it already is. Most doctors I know would accept a death rate for COVID-19 somewhere between 0.4 and 1.3% based on the best data we currently have available; incredibly dangerous, but not a death sentence. The diabetic patient with COVID-19 is most likely to recover without treatment, but if unchecked the virus could easily kills hundreds of thousands or even millions. That’s what happens in most dangerous, contagious illnesses; if unmitigated, it will kill far too many people, but any particular person is still statistically unlikely to die. In fact, I spend a lot of my time saying to my patients I am testing for COVID-19 almost what Dr. Immanuel is saying. I don’t hug them, but I do offer a therapeutic hand on the arm and say, “I think you’re going to be ok. Most people recover from this and never have to be in the hospital. Let’s talk about what to watch out for and how you can feel a little better while your body fights this.” By believing that this virus is almost universally deadly for certain people, she is ensuring that her evaluation of her treatment numbers is biased, because she then cannot objectively compare her survival rates to the real death rates. Each case proves the drug was the key, miraculous cure, because she’s convinced that each patient she treats would have died without it.

Dr. Stella Immanuel:
So if some fake science, some person sponsored by all these fake pharma companies comes out say, “We’ve done studies and they found out that it doesn’t work.” I can tell you categorically it’s fixed science. I want to know who is sponsoring that study. I want to know who is behind it because there is no way I can treat 350 patients and counting and nobody is dead and they all did better.

Two things on this. Most of the COVID-19 and hydroxychloroquine studies that have come out have not been sponsored by any pharmaceutical company (I can’t think of any that have off the top of my head), and this is the first time I’ve ever seen someone accuse drug companies of fixing data to prove that there was no specific drug therapy available. (yes, yes, I know; they are just setting us all up for a vaccine).

But more importantly, there absolutely is a way that she could treat 350 patients with no deaths and it not be due to hydroxychloroquine, because many doctors around the country have exactly these same types of numbers without using it. In fact, this is almost exactly what my numbers look like. I don’t feel at liberty to disclose the numbers or any details from my clinic without authorization from those patients; but I have been treating at least 20-30 patients for COVID-19 symptoms and exposure daily for weeks, and evaluating a significant number for the symptoms of COVID-19 in the months leading up to the beginning of our surge 6-7 weeks ago. I have treated well over 350 patients for suspected COVID-19, and many have been positive for the virus. None of them have died, praise God. Would I be justified in attributing this to something I am doing? Is it my particular form of counseling and reassurance? Is one of the symptomatic/supportive treatments I am recommending, like tylenol for body aches or hot tea with honey for sore throat, secretly an anti-COVID-19 miracle drug? Does my breath inhibit COVID-19? Of course not. The difference is that none of these have a theoretical mechanism of action against COVID-19 (although my breath may encourage social distancing), and many medications like hydroxychloroquine and budesonide do. I am extremely hopeful that studies will prove some clinical setting or scenario where these really are useful for COVID-19; but using before then because of unreliable anecdotal evidence is irresponsible.

We would be better served looking at my patients, if we could. Some were only recently diagnosed and, as we’ve already stated, aren’t out of the woods yet. If you don’t think I’m deeply concerned about some of these patients getting sick in the next week or two, you haven’t been reading my blog. Many were exposed but did not develop the virus. Many had only a mild clinical course and few risk factors, including age. Many had symptoms that meant they would screen positive for further evaluation for COVID-19, but were actually ultimately due to something else; a bacterial pneumonia, a COVID-19 unrelated COPD exacerbation, migraine headaches, pregnancy. Do I get to count all of them in my ‘COVID-19 treatment’ numbers since I saw them for suspected COVID-19 based on their presenting symptoms? More importantly, these patients self-selected to my clinic by not being ill enough to need to call 911 or present straight to the ER, or by not being elderly enough or having enough medical complications to already live in certain very high-risk settings, like a long term skilled nursing facility, where they would be evaluated by another doctor entirely. If I had placed all of these hundreds of patients on hydroxychloroquine, zinc, and azithromycin, (and if none had adverse events or serious reactions to these medications), their outcomes would have been exactly the same. The only difference would be that they would have purchased and taken unnecessary medications and I would be convinced that I have locked-on to the miracle cure. After that, if any of my patients did die from COVID-19, I would probably be convinced I was still beating the odds.

Dr. Stella Immanuel: (08:21)
I know you’re going to tell me that you treated 20 people, 40 people, and it didn’t work. I’m a true testimony. So I came here to Washington DC to tell America nobody needs to get sick. This virus has a cure. It is called hydroxychloroquine, zinc, and Zithromax. I know you people want to talk about a mask. Hello? You don’t need mask. There is a cure. I know they don’t want to open schools. No, you don’t need people to be locked down. There is prevention and there is a cure.

Do not trust anybody with your medical care who tells you don’t need prevention because you can just do treatment. Please wear a mask.

Dr. Stella Immanuel: (08:48)
And let me tell you something, all you fake doctors out there that tell me, “Yeah. I want a double blinded study.” I just tell you, quit sounding like a computer, double blinded, double blinded. I don’t know whether your chips are malfunctioning, but I’m a real doctor. I have radiologists, we have plastic surgeons, we have neurosurgeons, like Sanjay Gupta saying, “Yeah, it doesn’t work and it causes heart disease.”

I’m a real doctor too and I believe in evidence based medicine. Also, take that all of you radiologists, would-be-plastic-surgeons, and neurosurgeons who did better than me on your boards (you know who you are. Miss you guys); I’m a real doctor!

Dr. Stella Immanuel:
Let me ask you Dr. Sanjay Gupta. Hear me. Have you ever seen a COVID patient? Have you ever treated anybody with hydroxychloroquine and they died from heart disease? When you do, come and talk to me because I sit down in my clinic every day and I see these patients walk in everyday scared to death. I see people driving two, three hours to my clinic because some ER doctor is scared of the Texas board or they’re scared of something, and they will not prescribe medication to these people.

This is clue number three. Just like Dr. Lozano and Dr. Procter, Dr. Immanuel has patients driving across the state to see her because they know she will prescribe these hot-button medications for them even when other doctors wouldn’t. If you don’t understand why this is problematic or how this distorts her treatment numbers, please see my prior posts on those doctors’ claims.

Dr. Stella Immanuel: (09:35)
I tell all of you doctors that are sitting down and watching Americans die. You’re like the good Nazi … the good one, the good Germans that watched Jews get killed and you did not speak up. If they come after me, they threaten me. They’ve threatened to … I mean, I’ve gotten all kinds of threats. Or they’re going to report me to the bots. I say, you know what? I don’t care. I’m not going to let Americans die. And if this is the hill where I get nailed on, I will get nailed on it. I don’t care. You can report me to the bots, you can kill me, you can do whatever, but I’m not going to let Americans die.

I’m choosing to leave this one alone for the most part. Dr. Immanuel has been widely lambasted on social media for holding a number of medical and non-medical beliefs far outside of the norm, some of which are heterodox religious ideas, some of which are conspiracy theories, and some of which are just plain strange. I think her comparison of doctors like myself to Nazi scientists and doctors because we aren’t willing to use unproven medicines and some of the other references in this paragraph hint at that. While I do think that this line of conversation sadly does have some value- it is important to understand if the people we choose to give credence to are reliable sources of truth- I feel that my calling here is to speak to Dr. Immanuel’s arguments, statistics, and scientific interpretations alone.

Dr. Stella Immanuel: (10:09)
And today I’m here to say it, that America, there is a cure for COVID. All this foolishness does not need to happen. There is a cure for COVID. There is a cure for COVID is called hydroxychloroquine. It’s called zinc. It’s called Zithromax. And it is time for the grassroots to wake up and say, “No, we’re not going to take this any longer. We’re not going to die.” Because let me tell you something, when somebody is dead, they are dead. They’re not coming back tomorrow to have an argument. They are not come back tomorrow to discuss the double blinded study and the data. All of you doctors that are waiting for data, if six months down the line you actually found out that this data shows that this medication works, how about your patients that have died? You want a double blinded study where people are dying? It’s unethical. So guys, we don’t need to die. There is a cure for COVID.

This is painful, because she’s absolutely right; dead is dead (although some of us believe that’s not true at all). And if in 6 months I have lost COVID-19 patients and a large, well-controlled, double-blinded placebo controlled study does overturn all the best evidence we have so far and proves that hydroxychloroquine would have saved those patients if I had just given it to everybody who thought they might have the virus or who had certain risk factors or a certain constellation of symptoms, I will be sad that I didn’t use it. I’ll write about it on this blog, and my agony over it will probably come through pretty clearly because I’m not great at hiding that kind of thing. But what I won’t be able to say is “it turns out Dr. Immanuel was right” or “it turns out Dr. Procter was right.” Because recommending a medication that later turns out to be useful based on bad data, misunderstanding statistics, shifting the goalposts of what it means to diagnosis an infection or what constitutes valid evidence, and indiscriminate prescribing designed to bolster my own confirmation bias is still wrong. What’s that saying, something about a blind squirrel is still right twice a day, and we shouldn’t… be blind squirrels… leading the blind? Being right for the wrong reasons is called being lucky (or in the absolute best case scenario, deeply intuitive), and it’s great for you and your patients; it isn’t something anyone can reasonably or ethically follow you in.

How many medications do you take? There are over 20,000 prescription drugs approved by the FDA; unless you take that many, there are probably some out there that might help a symptom or a condition you have; maybe even some that might save your life. We could put you on chemotherapy because you might have cancer. We could put you on daily antibiotics because it might prevent your next urinary tract infection. More to the point, we could treat you with chronic opioids because they have a mechanism for helping your pain, even if your pain is unlikely to have any long-term improvement from them and you run the risk of opioid dependence, a condition I treat every day and have seen ruin lives in ways you wouldn’t believe. We could treat every child who might have an ear infection with antibiotics, regardless of diagnostic standards and the very real risks of antibiotic resistant bacteria (not to mention diarrhea diapers). We could put every flu patient on tamiflu even though it can be a harsh medication and has only limited efficacy in limited clinical scenarios.

No Dr. Immanuel, it is not unethical to refrain from using a medication in a clinical scenario where it has no proven efficacy. This is the philosophy that led to the opioid epidemic and every day leads to polypharmacy, another very real killer of the elderly. We took oaths to first do no harm, and sometimes that means sitting in the tension and anxiety of an unknown future with our patients and admitting, regardless of our own hubris, that we don’t have anything special or prescribable to offer other than our sound advice, sincere compassion, and reliable information. In fact, this is actually a pretty big part of our jobs already.

If 6 months from now (or hopefully sooner) some reliable evidence shows that hydroxychloroquine has a use in specific scenario to treat COVID-19, I will be the first one to prescribe it. Until then, the anecdotal evidence isn’t strong enough, the mechanism of action not surefire enough, and the scientific evidence not promising enough to justify the type of widespread everyone-gets-a-dose treatment these doctors are espousing; and unfortunately, despite her passion and her compassion for her patients, Dr. Immanuel’s clinical evidence, at least as she has shared it here, adds to that data not even at all.

From this point the press conference continued for another half hour. America’s Frontline Doctors is prolific; since this video they have also released additional hour and even three hour long videos. Although I think there are many points from the remainder of the video that could be analyzed, including quite a few I agree with, some that need clarification or explanation, and some that deserve to be debunked, I have to accept my limitations and accept that at this point analyzing the remaining claims is not the most pressing use of my time.

My apologies to anyone who might have been waiting for me to address a specific point in the remainder of the press conference; please do not hesitate to get in contact with me with specific questions, which I may be able to integrate into future posts.

I have deleted the remainder of the transcript since I do not have plans to address the remaining points, but it can be found here and the video can still be found in various places across the internet.