Flu vaccines might be ineffective, so try… water (otherwise known as Oscillococcinum)?

A friend forwarded a press release issued by “LeBron Health” to me, and the quackery it contains is too delightful to keep to myself. But because the press release also trades on fear-mongering of a rather pathetic sort, it’s also an reminder of how uninformed or unethical some medical “professionals” are, and of how quackery can harm in scaring people away from effective treatment.

The press release discusses the upcoming flu season in South Africa, and in particular, how to cope with the H3N2 strain of influenza. The H3N2 strain of influenza is indeed deadly, having reportedly killed dozens of children during the most recent US winter. That’s not good, of course – we’d like the number of deaths to either be 0, or much closer to 0 than that.

However, the number of deaths and hospitalisations this winter have not been significantly out of the normal range – the flu is not killing more people than it typically does. Furthermore, it’s also quite routine for the CDC to “issue a health warning to doctors”, as they are reported by the press release to have done. A “health warning” is not an advisory broadcast regarding an impending apocalypse, but (typically) simply information that the CDC thinks practitioners might find useful.

The health warning itself also reports something quite mundane on an aggregate level (though of course not mundane at all if you’re someone who has had flu-related illness or death in the family). It simply says that the current vaccine can’t compete effectively against H3N2, and that everyone should be prepared for a bad flu season.

This is also routine – vaccine developers select flu strains in January to May (for the US), based on which strains they predict will be most prevalent, and vaccination then begins in October. Things can change between those two phases – they are 5 months or more apart, after all – and one of the things that can change is the seriousness with which you could have (with perfect hindsight) regarded the threat of a particular influenza strain.

But you can’t know, 6 months in advance, and so you make the most informed predictions you can. Some years, the vaccine works very well, because you picked the right strains, and other years it works far less well.

And here’s the frustrating thing: in December last year (when the flu season hit the USA), the same scaremongering was prevalent. We read that the CDC had “admitted” that the vaccine doesn’t work, just as in this local press release’s headline, which claims that “flu vaccines may not work”.

Well, the CDC admitted nothing of the sort, and the flu vaccine “works” just fine, within the parameters of how it normally works, where the reasonable standard is never “perfectly”.

Even though this might be a particularly bad year for the vaccine’s efficacy, it’s still going to be better at helping you to avoid influenza than certain other “remedies” would be. It will help more than prayer, it will help more than avoiding cellphone towers, and it will certainly help more than homeopathy (with the caveat that hydration is good, so homeopathy in extreme quantities might help a little bit, because water).

Homeopaths disagree, as you might expect them to. One of those homeopaths is Dr Erika Coertzen, who suggests that we take a “reputable medicine such as Oscillococcinum, the most popular homeopathic product for flu symptoms in France”.

homeopath
This box contains as much medicine as a microscopic box of Oscillococcinum does.

That quote tells us that Dr Coertzen and my understanding of what the word “reputable” means is as orthogonal as our understanding of the word “medicine”. We can also note that a “medicine’s” popularity is only relevant to sales, profit, and analysis of marketing and gullibility – it tells us nothing about efficacy.

As with all homeopathic “remedies”, there is no good clinical data to support the claims made in favour of Oscillococcinum as treatment for influenza. It’s not going to help you to “rebalance and heal”, and even if it is true (no citation is given for this claim) that a “majority of patients who take Oscillococcinum at the onset of flu-like symptoms show improvement or resolution of symptoms after reduced time”, if this is in comparison to patients who take nothing, then the placebo effect is a perfectly good explanation for this observation.

But I suspect that the data is more… what’s the technical term?… made up than that, or that it at the least involves some fairly extravagant inferences being made from a poor data set. Dr Coertzen says that patients “symptoms show improvement or resolution of symptoms after reduced time” – if this is true, the data should support this claim. Unfortunately, they don’t.

As assessed by the Cochrane Collaboration, where trials do show favourable results for Oscillococcinum, “the overall standard of research reporting was poor, and thus many aspects of the trials’ methods and results were at unclear risk of bias. We therefore judged the evidence overall as low quality, preventing clear conclusions from being made about Oscillococcinum® in the prevention or treatment of flu and flu‐like illness.”

Amusingly, the Oscillo.com website – of course not a neutral scientific arbiter – claims that “unlike other flu medicines, Oscillococcinum does not cause drowsiness or interact with other medications”. Given that Oscillococcinum is a homeopathic “remedy”, therefore containing nothing that might cause drowsiness or negative interactions, this claim only gains traction if you’re able to persuade people that homeopathy is at all respectable or efficacious – surely nothing that any “reputable” healthcare practitioner would do?

In her defence, Dr Coertzen isn’t ever quoted as directly suggesting that you not take real medicine also, which might be the only thing that prevents the Health Professions Council (HPCSA) Medicines Control Council (MCC) from chastising her for this batshittery.

However, if she is the “medical expert” quoted in the headline, telling the public that vaccines might not work and that they should consider alternatives does seem to be a direct encouragement to forsake medicine in favour of homeopathy, and I do hope that a complaint is laid so that the MCC HPCSA can then rule against this idiocy.

Briefly, on Oscillococcinum itself, you’d be amused to read up on it, as the story of its origins and composition is quite the catalogue of pseudoscience in action. While there might be nothing that trumps Scientology for batshittery, Oscillococcinum gives it a damn good try…

 

PRESS RELEASE (source)

Flu vaccines may not work, consider alternatives — medical expert

Global health authorities have cautioned that current flu vaccines may not prevent a severe new strain of influenza, highlighting the need to seek alternative ways to protect against falling ill this winter.

The US Centers for Disease Control and Prevention (CDC) issued a health warning to doctors during the northern hemisphere winter about the severity of the 2015 flu season. It said the current flu vaccination protects against three or four strains but is not a match for the dangerous H3N2 strain which has mutated and has contributed to more deaths and hospitalisations of children and the elderly. (See: http://www.health24.com/Medical/Flu/Preventing-flu/Flu-vaccine-missing-its-mark-20150112)

Nearly 30 children died in one of the worst flu outbreaks in the US over their winter. In SA, a new modified vaccine is now available to match two of three new strains, including H3N2. However flu can still be contracted if other strains are not covered by the vaccine (See: http://www.health24.com/Lifestyle/Winter-Wellness/South-Africans-warned-of-severe-flu-strains-20150420).

SA doctor and homeopath, Dr Erika Coertzen, suggests boosting the immune system naturally by following a healthy, nutritious and balanced diet, getting enough sleep, regular exercise and taking preventative natural or homeopathic medicines to counter the onset of flu symptoms.

“A reputable medicine such as Oscillococcinum, the most popular homeopathic product for flu symptoms in France, has shown to help alleviate flu symptoms such as body aches, pains, chills and fever without drowsiness or the worry of negative interaction with other medication. Oscillococcinum works with the body to help rebalance and heal, and is suitable for all ages. Oscillococcinum’s efficacy in reducing the severity and duration of flu-like symptoms is well-known. A majority of patients who take Oscillococcinum at the onset of flu-like symptoms show improvement or resolution of symptoms after reduced time” she said.

For product info visit http://www.lebron.co.za/, www.oscillo.com or call 021-403-6390.

Homeopathic anecdotes aren’t data either

When I tweeted the negative sentiment below, about the author of a book on how to ‘treat’ your toddler with homeopathy, little did I know that the irate replies would still be coming in 6 hours later.

homeopathyYes, my tweet was hyperbolic, and the answer to my question – in a direct sense at least – is most probably zero. But what the question hopes to provoke is reflection on the indirect consequences of recommending that parents treat one-year-old babies with homeopathic ‘remedies’ instead of medicine. Even if, as one person admonished me, the book claims to “aid basic ailments like constipation and insomnia. Hardly life-threatening.”

First, because the reply presumes that parents can diagnose a basic ailment in the first place. If a parent is told that her child’s constipation can be treated with homeopathy, she might persist with that course of treatment for long enough that the problem becomes more than “basic”, requiring proper medical attention. And the time wasted in seeking that, or in not giving the child proper medicine, could indeed be life-threatening. Ask Gloria Sam, the 9-month-old who died when her (perfectly treatable, and not life-threatening) eczema was ‘treated’ with homeopathy instead of a visit to a GP.

Second, because the book claims more than that, and my critic was cherry-picking examples. Other things that homeopathy can treat, only according to the Amazon blurb, are “breathing difficulties” and “vomiting”, both of which seem to be things that you’d hope concern parents more than simply inspiring the application of some sugar pills or water (in other words, a homeopathic “medicine”).

Because that is of course the third, and most important reason. Trial after trial has shown that there’s nothing to it beyond the placebo effect, something that a group of friends and I satirically demonstrated by joining the 10:23 protests a couple of years ago, where we each downed a bottle of a homeopathic ‘remedy’ (I think mine was arsenic). Here’s James Randi doing the same, taking a bottle of ‘sleeping pills’ as he often does to make this point (the clip also includes him making other arguments worth hearing).

And no, there’s no good evidence to suggest it has to be more than placebo, “because it works on animals” – we’ve got no reason to believe it works on animals any better than it does on humans (in fact, the perceived effect on animals seems to simply be an effect on humans, in terms of how they perceive the treatment and health of their pets).

But evidence isn’t what defenders of homeopathy are interested in. For them, anecdotal evidence is ‘argument’ enough, even though they would never stop to think about how they would reject similarly weak claims if they came in a version they don’t like. Kitten blood! It works for me! Crystals! Prayers to the Pink Unicorn! (Or, prayers to a ‘real’ god, just not one of the ones you happen to believe in.)

Racists defend their views with anecdotal evidence, as do sexists – reality is ignored in favour of confirmation bias. And we don’t think that doing so is a good, or a reasonable thing to do. Because the evidence is meant to matter, and the evidence isn’t “up to me”, and the experiences I might have had or not had. Part of the point of science is to provide us with resources that offer objective guidance, because we go into decisions knowing that – by and large – we’re too prone to various cognitive errors to be trusted.

The point is that a double-standard applies in people who are willing to defend their consumption and prescription of homeopathic ‘remedies’, in that they are willing to accept a very low standard of evidence on the grounds that the risks are low – “any responsible homeopath”, I’m told, “will advise their patients to take antibiotics where necessary, or to seek conventional treatment”.

But some homeopaths are less responsible than others. The coroners report was pretty clear in highlighting how Penelope Dingle would have suffered far less harm if not for her homeopath’s advice, and more generally, as Ben Goldacre makes clear in the Lancet, homeopaths simply get in the way of effective treatment:

Homoeopaths can undermine public-health campaigns; leave their patients exposed to fatal diseases; and, in the extreme, miss or disregard fatal diagnoses. There have also been cases of patients who died after medically trained homoeopaths advised them to stop medical treatments for serious medical conditions.

More prosaically, you’re simply wasting money if you spend it on homeopathy. This is one of the most annoying #middleclassproblems for me – alongside things like anti-vaccination sentiments, or obsessions with angels, or The Secret – in that it’s only the middle and upper classes who have the luxury of glamorising their anecdotal evidence in such a fashion. If homeopathy worked so well – given that it’s possible to produce it so cheaply – why would Bill Gates (etc.) not simply distribute it to those dying of malaria instead?

Of course “Western” or allopathic, or “chemical” (pick your favourite pejorative term) can’t cure everything. Nothing can. But homeopathy doesn’t outperform a straight placebo, meaning that any good effect you observe after taking a homeopathic remedy can’t have anything to do with that remedy. And much of ‘regular’ (by which I mean, real) medicine does. Furthermore, the stuff that doesn’t work – and the doctors that are quacks – tend to get driven out of the market over time.

Except for homeopaths, partly because of this almost religious devotion to “alternative” medicine (and the associated conspiracies around mainstream medicine), and partly because what homeopaths say, and prescribe, involves completely unfalsifiable claims. And that’s a bad thing – not only in general, but particularly when lives are at stake.

Check out What’s the Harm for a partial catalogue of homeopathy’s victims.

Don’t contaminate your water with water

imagesAs is so often the case, seriously-intentioned pieces of writing – if written by quacks – can be rather funny. And so it is with a report on a recent homeopathy conference in Barcelona, which I was alerted to by Andy Lewis (who is responsible for the excellent Quackometer website). If you read the report, you’ll discover that homeopathy is even more powerful than you might currently believe. For example:

physical contact with a remedy may not be required to feel its affects. So presumably, individuals in a placebo or control group could still be affected by the action of a remedy.

Translation: homeopathy is unfalsifiable, and we don’t care. In fact, it’s a virtue.

Dr. Gustavo Bracho, an immunologist from Cuba, … discovered completely by accident,that if he stored water (for his control / placebo group) next to a homeopathic dilution of the extract, the water would take on the same properties as the remedy.

Translation: one sample of water, with no detectable traces of the homeopathic “remedy”, tested as having the same properties as another sample of water with no detectable traces of the homeopathic “remedy”.

But on his reasoning,

if a remedy is already imprinted, it cannot be affected by another. So word of warning to homeopaths, and homeopathic aficionados out there – make sure you keep your blank pellets and water far away from your remedies.

Because imagine the panic that might set in if you’re racing against the clock to cure someone’s dread disease, and all of the water you thought was “blank” had brushed against the glass containing water intended to banish faeries (or something. I’m not quite sure how this is supposed to work.)

Cansa indulges the quacks (and students indulge the homeopaths)

So, as mentioned in a Daily Maverick column, I was recently asked to grant a student an extension on an assignment deadline. Her request was accompanied by the “medical certificate” below:

sicknote

Yes, that is from a naturopath, who also advertises skills related to iridology (your eyes, the iris in particular, being a reliable source of information about your health), herbal tinctures, and homeopathy. And in what you’d hope is a joke, but isn’t, the course in question is explicitly about evidence-based decision-making. Worse still – during the week this particular assignment was due, the lecture topic was pseudoscience, with explicit reference to homeopathy.

A reader encouraged me to submit a complaint to the Registrar of the Allied Health Professions Council, which I’ve done as per the text below:

I would like to formally bring a matter to your attention, as Registrar of the Allied Health Professions Council. The attached note, bearing the letterhead of Renata Zijp (Reg A9803; Prac 0805564) was submitted in support of a student’s application to be granted an extension on an assignment in my course at the University of Cape Town.

While I realise that it’s not within your purview to completely eliminate pseudoscientific professions such as homeopathy, I would hope that legislation and common sense both argue against practitioners in these fields issuing certificates such as the one attached.

The certificate makes no mention of the ailment that was diagnosed, nor does it offer any information as to when the student would be fit to return to her studies. In other words, as a piece of testimony as to the medical condition of the student, it is useless for two reasons: the fact that Zijp is a practitioner of professions of dubious value; and even within those professions, has offered testimony that is useless and even misleading.

It is misleading because, in using the imprimatur of science, a less attentive or more gullible member of the academic community might accept such a certificate as a legitimate reason to grant the student an extension. It is not, and presenting certificates such as these is an insult to those who suffer from genuine ailments, and to the professionals who treat them.

Finally, even though the AHPC must of course concern itself with matters directly related to the professions in question, we arguably all have a responsibility to hold other citizens to account for the contributions played in promoting reason and rationality, or the converse of those. Students (ironically, in this case students in a course teaching evidence-based decision-making) should not be given the impression that these sorts of certificates have any merit, and practitioners should be dissuaded – if not barred – from issuing them.

If you encounter any similar instances, you can get in touch with the Registrar of the Allied Health Professions Council, Dr Louis Mullinder, at [email protected] to officially lodge a complaint.

Incidentally, my complaint might bear some fruit, seeing as I’m reliably informed that the practitioner in question “is registered as a naturopath, but not as a homoeopath. It is a breach of the Regulations to the Act to give the impression that she is registered as a homoeopath. I expect that the Registrar will deal with it harshly – quite apart from the highly problematic wording of the actual certificate.”

While on the subject of quackery: CANSA, the country’s main cancer advocacy organisation, is promoting and marketing an untested supplement. Prof. Roy Jobson of Rhodes University pharmacology dept criticised them, and they responded with a lawyer’s letter threatening to sue.

Doing Reiki in your sleep

newvoiceOne of the many benefits of believing utter bulls**t is that your claims need to be limited by nothing other than your imagination. I was alerted to a goldmine of quackery today via an Andy Lewis tweet about Siri for homeopaths. Not simply the sort of Siri that can answer questions like “where can I buy 10 000 sugar pills” – a Siri that can actually make “medicine” for you.

It’s true (at least, the fact that someone makes this claim is true). The picture at top-left is is a “voice-programmed remedy maker“, which is a marvel of efficiency and simplicity.

In use, the device is held close to the mouth, a button on the side of the Remedy Maker is pressed in, and you speak the name of a Remedy you want immediately followed by the Potency (if any). The button is then released and a “beep” sound is heard confirming that a remedy has been recorded and stored. Then the device is placed on a table or flat surface and a small bottle of tablets, or even just one or two tablets can be placed in the small 30.3mm ( 1. 3/16″ ) diameter Stainless Steel Well that is fitted in the device. A switch next to the Well is operated and held down for about 3 seconds, and then released, and the device again beeps to confirm that your remedy has been made.

What’s that? You’ve run out of tablets? That’s no problem at all – simply place your finger in that metal well, operate the switch, and marvel as the device transfers “the vibrations directly into the body. This makes the device ideal to use as an emergancy first aid device, for example it could be used to make Apis Mellifica, which is a powerful Bee Sting Treatment, or one could give a dose of Malaria Officinalis, which is considered by many to be useful in Malaria prevention.”

At a bargain price of 395USD, this is Profitus Maximus (seeing as we’re talking sciencey).

The makers have thought of everything. It matters not if you have a thick accent or speak in a strange dialect, because “Words are used to represent a thing or situation. Many different words (even different in language) can be used to represent the same thing.” The device understands abbreviations. If you’re speaking in a loud, crowded environment, no matter – it only listens to your voice.

And you don’t even need to know which “medicine” you need! “The special beauty of this device is that within seconds you can be making vibrational remedies from literally anything you can think of, … even the illness itself. “My Throat problem”, for example, or “The pain in my leg” etc.”

If you feel like some light entertainment, spend a few minutes browsing the site. If you ever wished you could do Reiki while sleeping, or talking on the phone, go find out about the White Mountain Energy Copier, which makes this possible. Worried about the end of the world? There’s info on that, as well as a handy (for Muslims) description of why and how the Kabbah needs fixing.

For skeptics, Randi “and other closed-minded behaviour”, there’s a message for you too, which concludes with:

We don’t feel we need to prove or justify anything, our products work and we have thousands of satisfied customers, many of which are busy using our devices to save lives right now, or using these devices to improve their own wellbeing.

If you are one of the skeptics, all I can say is I am very sorry for you, and I hope one day that you will choose to open your eyes. In the meantime don’t bother to email me with your abusive and childish comments as your emails will not be opened and read.

Then there’s a link to a website called Coping with Disbelief – but the URL currently redirects to a website advertising a “Fiber One” breakfast bars and cereals. Handy, for those who are full of s**t. (This might be intended as a joke on the part of White Mountain, which would certainly offer reassurance that they’re not completely crazy).

By the way, if you don’t know Andy’s site The Quackometer – dedicated to debunking quack medicine, be sure to check it out, especially his detailed work on Steiner-Waldorf racism, mysticism and other reasons for parents to run a mile.

What’s the harm? Well, homeopathy could (indirectly) kill you.

The letters Penelope Dingle sent to Francine Scrayen make for very sad reading. Scrayen was “treating” Dingle’s cancer, diagnosed in February 2003. Dingle’s sister is now suing Scrayen, and it’s easy to understand her motivations for this on reading not only the letters, but also the coroners report following Dingle’s death :

In my view the deceased’s rectal cancer was present and causing bleeding and other symptoms from at least 31 October 2001. During the period 31 October 2001 until at least the end of November 2002, the deceased regularly described the symptoms of her rectal cancer to a homeopath, Francine Scrayen. It was not until November 2002 that Mrs Scrayen and the deceased discussed the possibility of reporting her rectal bleeding to a medical practitioner and it was not until 5 December 2002 that she first reported those problems to a doctor.

I accept that Mrs Scrayen believed that the deceased had suffered from haemorrhoids years earlier and the bleeding and pain was “an old symptom coming back”, but a competent health professional would have been alarmed by the developing symptoms and would have strongly advised that appropriate medical investigations be conducted without delay.

As I’ve said before, pseudoscience doesn’t only cause the (relatively trivial) harm of lightening the wallets of the gullible. When it’s taken seriously, it can not only result in these sorts of tragic stories, but also helps to contribute to a general climate of unreason, where people become less discerning about what to believe and why to believe it. In fact, an increasing concern is the ways in which this climate of unreason can be leveraged in favour of political and economic interests. Conspiracies are attractive to many folk, because we sometimes prefer grand narratives to the conclusions reached via the application of Occam’s Razor (on this topic, Rosenberg’s new book The Atheists Guide to Reality makes for good reading).

Alternative medicine that works is simply called “medicine”, as Dara o’Briain reminds us here:

The Dingle story is now a few years old, but it’s back in the public eye thanks to the recent publication of the coroners report and Dan Buzzard’s highlighting of that report’s contents. And now, Scrayen has sent Buzzard a cease and desist letter, demanding that he retract his allegations regarding her complicity in Dingle’s suffering and her potentially avoidable death. You can read Buzzard’s two posts on Scrayen via that last link, and it’s difficult to see how Scrayen thinks he’s done anything wrong – except, of course, for exposing her as a dangerous quack.

It is ultimately the consumer’s fault if she makes choices which endanger her own life. The issue here, though, is that while Dingle (and most of us) live(d) in a society which protects us from all sorts of misrepresentation and fraud, that protection is absent in the case of things like homeopathy. The politically-correct, relativistic way in which opinions and evidence are treated make us afraid to tell people that what they believe is sometimes nonsense, and sometimes dangerous nonsense.

Medical aid schemes should of course not reimburse for homeopathic treatments. Pharmacies, who are associated with treatment and good health, should ideally not sell them, no matter how profitable exploiting the gullible can be. Pharmacies are of course free to sell anything legal, though – my point is more that it’s unfortunate that they often don’t take any proactive role in reminding consumers that what they’re buying is pure placebo, and shouldn’t take the place of medicine.

Most important, perhaps, is that in an age of manic labelling of everything consumable, down to the most minuscule ingredient, it’s an almost criminal neglect that legislation doesn’t exist to force producers of homeopathic remedies to spell out the simple fact that a glass of water will “treat” your ailment just as effectively as a homeopathic “remedy” will.

Also see Angela Meadon’s post on this, reminding Scrayen that she can’t bully Buzzard into silence, and that the Streisand effect might well result in her attempts to do so having the opposite effect to what she hopes.

Woo-woo fest comes to Wits

As published in Daily Maverick

Did you know that “millions of people in SA have had their own personal experience with ETs and UFOs”? If you didn’t, Michael Tellinger has arranged a conference just for you, this November in the Linder Auditorium at the University of the Witwatersrand. It must be true, seeing as one of South Africa’s most prestigious universities is hosting the conference. Continue reading “Woo-woo fest comes to Wits”

On Hitchens and the defense of reason

As submitted to The Daily Maverick.

On hearing that Christopher Hitchens had been diagnosed with oesophageal cancer, one response from a self-proclaimed man of god was the following post on Twitter: “God 1, Hitchens 0”. The motivation for such a callous response to a usually fatal disease (fewer than 5% of sufferers are alive after 5 years) is easy enough to trace: Hitchens, along with Dennett, Dawkins and Sam Harris, is one of the “4 Horsemen” of a groundswell of resistance to the unreason that is exemplified by religious faith, and he is thus a direct threat to the mysterious legitimacy that faith-based claims enjoy.

What our divine scorekeeper does not (of course) dwell on is the fact that according to his beliefs, all deaths are attributable to god, and that he could therefore just as well add another notch to this metaphysical bedpost if his mother, for example, were to die an equally unpleasant death. God’s victory is inevitable, as either she takes a believer “home”, or she smites down an unbeliever. Either way, a civilised response to human trauma is sympathy, rather than gloating. Continue reading “On Hitchens and the defense of reason”