The RxISK post on Medications Compromising Covid Infections resonated with many. Its basic premise that many of the drugs we are on might compromise our ability to fight the infection seems close to self-evident. It made a call to the powers that be to ensure that data was collected on the meds that people were also on at the time of death from Covid.
Within the UK and perhaps in most other countries, the people particularly likely to be infected were those in care homes. It is now clear there is likely little if any monitoring of the medicines the men and woman living there were on and almost certainly there will be no follow up on what appears to have been a scandalous lack of “care”.
Some of the responses we received typified the disastrous effects of the specialisation that now characterises medicine with respirologists aghast at the recommendation that the antipsychotics some people might be on should be reviewed. The response conjured up images that to do something like stopping an antipsychotic risked having crazed axe-wielding maniacs running amok, when the typical person taking an antipsychotic is likely to be an elderly woman, living in a care home, who cries out once too often because of discomfort or loneliness.
But the ultimate comment on what has happened to medicine came when we approached the BMJ and the Lancet, with a trimmed down, more academic version of the piece. Both journals are as stuffed full of Covid articles as it is possible to be – add Covid to the title of a Denis the Menace cartoon and you are likely to get published.
But not us or not this.
We didn’t bother with the NEJM because its editor, Jeff Drazen, has in the past called one of us a Research Parasite, and likely would have a similar epithet for the other of us.
So the breaking of the Surgisphere humbling of the Lancet was a moment of sheer delight. Richard Horton, the Lancet editor, had been ranting in the Guardian newspaper for months at the lamentable failure of the British Government to adhere to the science. Ranting self-righteously, as he is prone to do.
Oh, what a come-down to find his castle was built on sand and the tide had Surgisphered him with a Fake Article the Lancet had rushed in unseemly haste to publish. This should demolish any self-respect he could possibly have or the respect in which others might hold him.
Perhaps Dominic Cummings, who is linked to these kind of operations,. was taking revenge and did Horton in. If so, it would be difficult to know whose side to take.
Horton has form here. In early 2005, before a House of Commons Select Committee he laughed at the idea that falsified data could be a problem in medicine or in journals like his – not realising it seems that his journal had been just about to produce scandalous recommendations for using SSRIs for childen – until the media rescued him.
The scandalous article he was just about to publish is one which he would never have accepted had he paid any heed to the series of articles sent to him on the risks of suicide on SSRIs over the previous few years and the fact that the medical literature was back in 2002 increasingly ghostwritten with the harms drugs do buried in his and other journals.
But he rejected all these and told the politicians that Fake literature was nothing much and nothing to be worried about.
Jeff Drazen, the editor of the NEJM, had a similar reaction – under his auspices in response to media queries, the New England Journal maintained that it is not responsible for the integrity of the data sources for the articles it publishes. Oh how sweet to find him also Surgispeared.
The BMJ has been little better, with Richard Smith saying outright he would never publish anything about SSRIs and suicide. He rejected or contributed to the rejection of countless articles in these areas while pontificating about the risks of medical journals becoming a conduit for pharma to launder their clinical trials. He was also responsible for publishing the Beasley et al meta-analysis in 1991, over-riding his reviewer, which saved Prozac, but which was not much more genuine that the Surgisphere article.
More recently, with Elizabeth Loder as research editor, BMJ have published the most astonishingly egregious junk by Lu et al sponsored by the Clay Center – as close to junk as the Surgisphere articles, claiming that SSRIs save lives and Warnings should be removed, while at the same time Loder appeared to be straining every sinew to prevent the publication of Study 329 or other articles about treatment hazards.
So, I have done something unusual and added to my CV in a place of honor the title of an article along with its rejected for publication in the BMJ and Lancet details.
Our leading journals, whose editors commonly portray themselves as or are portrayed by others as fearless, are in fact scared silly to run anything that casts doubt on the desirability of having the entire population swallowing everything they could possibly swallow every day of the week.
For three decades the greatest concentration of Fake News on earth has centred on the drugs a doctor gives their patient. Donald Trump is a johnny-come-lately to the idea of Fake News.
The editors of the New York Times or the Guardian would until recently have been fired for not checking the integrity of the data sources of any articles they run, and publishing the kind of stuff Lancet, NEJM, BMJ and other major journals publish routinely.
Until recently we would have been safer having our clinical trials published in the NYT and Guardian than the NEJM but this too may now be changing – it is increasingly difficult to trust the Guardian, who delighted in breaking the Surgisphere story, in the way we once did.
One of the main reasons to have RxISK and Samizdat is to be able to mention that whaddya know drugs can have side effects and that more and more health services are not the same thing as better healthcare.