28 Comments
Sep 30, 2022Liked by Arnold Kling

Getting through medical school without knowing about Bayes is a shame

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Hah… I foolishly had that “diagnostic procedure” done under similar circumstances once. Do not recommend, worst episode ever!

On the vaccine, my wife and I are on the border for getting a booster age wise. I think it’s probably a wash for me. I’m also in really good shape and training for a marathon. So my risk level is pretty low and I can’t afford a shot reaction right now. Maybe in a month? Maybe not though…. I don’t see a big upside even for me anymore.

Our kids are young athletic and healthy. I don’t see a statistical win for them at all.

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My son had covid. He basically had a mild fever for about an hour, and then was fine. No other symptoms.

No amount of "safe and effective" would justify giving him the vaccine.

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Strictly speaking that’s not very logical. There’s some amounting of safe and effective that would make it worthwhile to spare even a minor inconvenience.

How did you even know the kid had COVID if he only had a one hour fever? Unless we just happened to be getting tested for a travel requirement or something I’d guess most of the time people who are only a tiny amount sick for an hour would never be tested

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What is surprising about Heyer's anecdote is the current CDC messaging on the Covid shots doesn't hide their limitations. The shots may reduce personal injury from Covid. But they do not prevent transmission or infection and they can cause adverse health effects. The benefits of the shot are so minor and the risks not insignificant that a number of governments outright discourage the shots for the younger population.

One doesn't need a PhD in biology to have concerns about the position of American medical associations / doctors on the Covid shot. One just needs to be aware of information and be independent minded.

Warning: knowledge of what the American medical system advocates and how their position contrasts with actual medical information may lead to a loss of confidence in the American medical system. This is highly unfortunate. But it is not the fault of the "layman" being observant and self-educated!

We live in a curious moment where professionals are willfully choosing agenda over facts and being dismayed when amateurs notice. If this were quantum physics the professionals could get away with chicanery. But with Covid shots the evidence is too obvious. No matter the cheerleading for the shots, the reality of them being an overhyped, underperforming product is understood by any who do just a modicum of reading.

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> We live in a curious moment where professionals are willfully choosing agenda over facts and being dismayed when amateurs notice.

I think all that's curious about the moment is that there's an issue (pandemic) that caused amateurs to notice in a systematic way.

Doctors have always put their "agendas" ahead of patients. This isn't to say that doctors are intentionally giving bad advice, but most people give the advice they were trained to give. The doctor who's practiced in invasive surgery is going to recommend that. The guy who does minimally invasive surgery is going to do that. In either case, the doctor doesn't want to lose the patient, but if you die, it's probably not going to affect him too much. If you die, however, it affects you quite a lot. So you have way more incentive to get it right, even if both of your incentives are nominally "aligned".

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Even on the weak and likely corrupt clinical trial data, there was never a good reason for people under 65 being vaccinated against this disease for personal benefit unless they were morbidly obese. As we now know with certainty, there was never any reason to vaccinate medical personnel either since the vaccines don't stop infection and transmission at all, thus there is no reason for anyone to get boosters who don't fall into the well known risk categories of being very old and very fat.

As for the side effects- I am here to tell you that we won't know the entire panopoly of side effects for at least another 3 years. We have run history's largest Phase III drug trial, and are now in the process of monitoring the results with post-marketing surveillance. This was criminal behavior.

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The biggest argument against the vaccines to me is that they make you really sick. No vaccine has ever made me that sick. It doesn't feel right.

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My wife and I long ago agreed to give our children only those vaccines that been sufficiently studied over a long period of time. This was based on conversations we had with medical experts and from her own nursing training.

I think many people assume that our stance is a political position, rather than a long-held principled decision that was (until a year ago) common sense among the medical profession.

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You don't need to take Zvi's word for it here. I think you know enough to know that evidence from randomized clinical trials is better information than the kind of anecdotal garbage Heying cites. And honestly, Heying mentioning her credentials here is a joke. She was a bio professor at a nothing college with a background in evolution and animal behavior. This is no more relevant than any random soft science degree.

We can have a conversation about the safety issue, because that has not been studied with quite the same experimental rigor as effectiveness has in adults. Same goes for ivermectin as a therapeutic. But when someone says the vaccines are ineffective, that means that person is a bad source on this issue.

If you want a well informed perspective that's a reasonable counterpoint to Zvi on the vaccines, check out Vinay Prasad.

By the way, I agree that there is no good reason to vaccinate kids.

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> But when someone says the vaccines are ineffective, that means that person is a bad source on this issue.

How so? No vaccine is 100% effective, and it does definitely provide protection, but when it comes to preventing illness and spread, the COVID vaccine is both less effective and less lasting than was originally promised - and less than we expect for most vaccines people get. Those are certainly valid reasons to criticize its effectiveness.

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I basically agree with that, but it isn't what Weinstein and Heying are saying. Also they think ivermectin works as a prophylactic, which is legit nuts.

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Strange thinking; Arnold rejects a procedure for haematuria, possibly indicating the existence of a tumor. Usual procedure is a quick, utterly harmless ultrasound. Then he is OK with the new and unproven genetic vaccines, for which there have been more reports of mortality and morbidity in the last two years under the Vaccine Adverse Events Reporting System (VAERS) than for all other vaccines combined for the last 30 years, and even though mortality and serious morbidity from the disease is very low, even among the elderly if they are healthy.

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You prompt another question. Would you favor the ultrasound if you had to pay for it out-of-pocket?

As for the vaccine, what is your basis for labeling it unproven? Does it not drastically cut the mortality rate in elderly, obese, and those in poor health? Does it not significantly reduce the mortality rate in somewhat younger population? Are the side effects observed to date anything close to that? What else do you need for proof?

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I could not figure out from Haying's quote the parameters of her cost benefit analysis. What she thinks the doctor thinks of her, what she used to think about lockdowns, and pharmaceutical therapies seem quite irrelevant as is her PhD in biology. Either the vaccine reduces bad outcomes for the vaccinated person and others at low cost or it does not. For me having been getting vaccinated for dozens of different diseases over my 80 years, 5 more doses of this one has a high Beysian prior.

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Unfortunately, doctors have several incentives that override providing sound independent advice to patients. First, doctors typically treat based on established authoritative guidelines even when those guidelines are questionable or out-of-date. Doing so protects against malpractice claims. In addition, sticking with guidelines, rather than conducting independent analysis, is far less time consuming. Second, in many cases physicians have financial incentives and/or malpractice avoidance concerns in recommending procedures that are either of questionable efficacy or necessity. Third, many (if not most) doctors are now employees of large health care institutions which have their own policies and guidelines. Thus, employment security can be a factor.

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Your comments all seem valid to me. On the other hand, what you describe as negatives might still be the best alternative. What percent of doctors are capable of giving better advice than the guidelines? (Or what percent who deviate have worse outcomes than the guidelines?)

To emphasize my point, what percent not only have heard of Bayes theorem but understand how it applies to their patients' diagnosis and treatment?

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Explanation: Medical-Pharmaceutical-Complex. Money. Just as conflicts and war is good for the Military-Industrial-Complex. In the UK, the average age of death from (attributed to) CoVid is 82... that’s 1.5 years beyond life expectancy in the UK... with 95% of those with one or more comorbidities. That means end of life individuals with less than 12 months left on the clock if lucky. Vaccination for ‘flu or CoVid merely ‘saves’ the patient to die from some other opportunistic infection or what already ails them. Many of these don’t want to live anyway, their quality of life being so poor. (Top four comorbidities: dementia; diabetes, chronic renal disease, chronic cardio-vascular disease).There are no vaccines to prevent these and no vaccine against death. Pneumonia which is a generic name given to the end stage of all respiratory infection used to be called ‘the old man’s friend.

Why anyone would think they should be vaccinated, whatever age, against a virus, infection from which causes a disease with symptoms from the same symptom group shared with all the other respiratory viruses, generally called the Common Cold, is beyond me, and can only be accounted for by brain failure.

It is worth considering that during the initial Pfizer Human trial (such as it was) a near equal number in both cohorts (placebo and active ingredient) got symptoms from the same set we associate with the Common Cold. Only PCR Testing identified those testing positive for SARS CoV 2 and therefore deemed to have CoVid 19. So the ‘disease’ affected both groups about equally, but in some it was called CoVid 19, in the rest Common Cold. That is how stupid the whole affair is and those who jettisoned good sense to be sucked in by all the fear mongering and absurdity should hang their heads in shame.

The butcher’s bill is not yet complete, both from the effects of the lockdowns and economic calamity, the abuse of children and the elderly, and the fatalities and serious injuries from the so-called safe, so-called vaccines.

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Dude if I could be vaccinated against the common cold that would be amazing. Being sick sucks. I'd much rather vaccinate and avoid being sick (or in the case of COVID shorten the period of sickness to a single day).

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"That means end of life individuals with less than 12 months left on the clock if lucky."

Sounds like a ridiculous exaggeration to me but I'd be curious if you had a data source to somehow support the claim.

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I would suggest you read the two papers just published by Dr. Aseem Malhotra, a prominent cardiologist in the UK. Here is a short video he made introducing the papers. I'm stunned YouTube has not removed it. https://youtu.be/MtE0I5FqHPs

Dr. Malhotra was an early advocate of the vaccines who went on British TV, where he appears often, to promote them. Data available since has made him reverse his opinion. The two papers below explain why.

The two papers are linked below.

Part 1: https://insulinresistance.org/index.php/jir/article/view/71/224

Part 2: https://insulinresistance.org/index.php/jir/article/view/72/228

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Our kids have had COVID twice. We aren't getting them the vaccine.

Neither of us are getting boosters ever again either.

We got a very curious email from my work this week. They have dropped the vaccine requirement (something that used to be of paramount importance and justified ending someones career if they refused less than a year ago) for everyone EXCEPT people ranked VP or above. If you want to be a VP, you need to have two doses of the original Pfizer/Moderna or one dose of J&J.

As a matter of stopping the spread, I would be hard pressed to come up with a justification for how this would protect our executive committee.

But as an initiation right for membership in the inner party, it makes perfect sense.

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founding

Occasional observation suggests that physicians are prone to forget what they might have learned in their early training, about probability and evidence. We are not hard-wired for subtle statistical analysis and judgment.

Sometimes, there are issues of incentive-alignment; for example, if physicians have a revenue stake in diagnostics.

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"Do your own research" runs up against Brandolini's law, which is sometimes called "the bullshit asymmetry principle." Heying is subject to it, it appears, having indulged in online bullshitters. This is bad, though common: https://theredquest.wordpress.com/2021/01/09/the-most-stridently-asserted-opinions-will-disappear-down-the-memory-hole/.

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Another Bayes point. See how many normal physicians have had their own kids vaccinated. Pretty sure it's the vast, overwhelming majority. Also take Oster over Heying.

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Remember; MD are to Science what mechanics are to Engineering, just practitioners of the Art. They are absolutely necessary to keep our bodies and cars running in an advanced society where we live a lot longer than our evolutionary design supports.

However, MD/PhD and PhD engineers on race teams are another issue.

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I think I understand what you mean and agree the point is valid but your analogy is really messed up. Engineers are to science exactly as MDs are to science.

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Zvi?

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