Comments on ‘Offener Brief von “Ärzte stehen auf” für einen verhältnismäßigen und evidenzbasierten Umgang mit Sars-Cov2

I was asked on Facebook for my opinion on an Open Letter from a large number of German medical doctors. Apart from posting it in a Facebook discussion, I publish it here, as the questions that are raised in the letter are fairly common.

This letter asks for a scientific debate on covid-19. I fully agree with that. However, the implication of the letter is that right now, the debate is unscientific, some voices are stifled and there is altogether too much panic. I beg to differ. I am not giving a line-by-line analysis, that should take too long. Just a few points that stood out for me.

1) A number of courageous individuals are attacked, ignored, stifled. I don’t know all these names, but one stood out: prof. Ioannidis. He has indeed been criticized. However, what I would like to point to here is that further on in the letter, it is said that the infection rate for covid-19 is comparable to the seasonal flue in Bulletin of the WHO, Article ID BLT.265892. Two remarks on this statement. a) It is presented as a WHO statement, but this is not true. It is a paper published in a WHO journal. b) The author of this paper is prof. Ioannidis. So he is allowed to publish his conclusions. And yes, this elicited criticism (see for example https://rapidreviewscovid19.mitpress.mit.edu/pub/p6tto8hl/release/1), but that is how science works.

2) The wrong data are presented in the media. Well, the list that is required by the authors (how many are really ill, how many need ICU care and intubation, how many died?) are provided by the Dutch news (just not number of intubations). How many have symptoms is not known.

3) PCR is not a good diagnostic test. I’m not going too deep into this often repeated argument. It is simply not true. My question is simply this: if PCR is such a bad test, how can there be such a clear correlation between number of positive tests, number of hospital admissions and deaths?

4) It is just like seasonal flue. Again, often repeated and untrue. Again a question, rather than an argument: if it is not worse than seasonal flue, why are nursing wards and ICU’s at capacity? Why all those excess deaths? Why do the need refrigerated trucks as back-up morgues in a number of places?

5) Cloth masks are unhealthy. Nursing staff in ICU wards wearing FFP2 masks have a normal oxygen saturation. There have been a number of studies, and none of them show any adverse effect on oxygen saturation. You should wash them every day.

6) “We in the World Health Organization do not advocate lockdowns as the primary means of control of this virus,” says dr. Nabarro. Just google this quote, and you’ll find it is a quote-mine (quote taken out of context, which distorts its meaning).

Nabarro said: “We in the World Health Organization do not advocate lockdowns as the primary means of control of this virus. The only time we believe a lockdown is justified is to buy you time to reorganize, regroup, rebalance your resources; protect your health workers who are exhausted. But by and large, we’d rather not do it.” Nabarro then went on to describe potential economic consequences, including effects on the tourism industry and farmers or the worsening of world poverty. (source: https://khn.org/news/fact-check-world-health-organization-did-not-change-its-lockdown-stance-or-admit-president-trump-was-right/ they checked with Nabarro!)

7) Questions are raised over social distancing and wearing face masks outdoors. The evidence for the effectiveness of social distancing is huge (check on scholar.google.com). Mask wearing is more complicated, but the latest data shows positive effects. Furthermore, as there are no side effects (see 5) it is a fairly simple method so suitable even when the positive effect is small. (Personal note: I hate these things, but I hate the pandemic even more.)

I could go on, but this is for now enough. A final word on the signatories. I observe that there are no virologists or epidemiologists. Lots of dentists, at least one vet and many, many general doctors or internal medicine specialists. Quite a few from what we in the Netherlands call ‘alternative medicine, some combining this with regular medicine. Some psychologists. That does not disqualify them, as most of them do have a medical training. But so have I (MSc Biomedical Sciences, PhD in Medical Sciences, physiology). I have judged the arguments in this letter, and find them lacking scientific evidence.

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