I retired before the GMC got round to enforcing re-validation, a kind of elderly drivers test for doctors supposedly left behind by the march of scientific progress and dementia, if not addiction to golf. Subsequently I removed myself from the medical register to save money. But since COVID I’ve been wondering if I’d even be able to pass a re-validation test now, though I think I would have done so easily back in 2008.
The reason is that between them, the CDC, WHO, SAGE and everyone else pretending to medical authority has reversed or otherwise radically changed many of the basic principles I was taught, and worked with, throughout my medical career. I suppose whether I would fail a GMC test would depend on whether “the profession” now takes its lead from the vacillations of these state-sponsored and industry-funded bodies, and I just don’t know about that, because they have been so quiet in commenting on the astonishing recent changes in medical truth.
Be that as it may, here’s a list of things that have changed “since my day” (meaning in most cases “since 2020”), which is probably not exhaustive.
- A pandemic used to be an infection which spread round the world causing many deaths. Now it just means an infection supposed to be spreading round the world (whose severity is measured mainly by the number of positive PCR tests). This is old news, the WHO having changed their definition in 2009, just before the H1N1 “pandemic that never was” which killed far fewer than a typical flu season would and about 10% that Hong Kong Flu did in 1968-9 and Asian Flu in 1957-8, despite the massive increase in world population.
- Herd immunity used to be what happens when epidemics infect enough people to die down for lack of susceptible victims. Last year, apparently at the behest of the Chinese Government, the WHO redefined it as the result of a vaccination programme only, and then had to pedal back quickly to a weird compromise position, which is what is now on their website. With such random mutability of basic epidemiological concepts, which box should I tick on my multiple choice questionnaire?
- A “case” used to be someone with signs and symptoms of a specific disease, confirmed by any necessary investigations. Now it means someone with a positive result of a test for which no clinical gold standard, sensitivity or specificity has ever been established.
- Even last year the CDC director said that asymptomatic spread of respiratory diseases happens rarely if at all. This is logical because spread depends on viral damage in the airways, which necessarily produces symptoms like cough which the virus needs to propagate. Now however the entire pandemic response has been about healthy people spreading the infection, on evidence that is, to say the least, thin.
- Lab tests used to be the last, confirmatory, stage of diagnosis made from history and examination. Now they are the sole diagnostic criterion, the WHO actually defining the condition from the PCR test, not from clinical signs or pathology. Many of the diagnoses now are based on lateral flow tests as a proxy for PCR as a proxy for a gold standard. And that’s adequate even though the CDC has dismissed the Innova LFD test we use as worthless.
- PCR tests before 2020 were excluded as screening tools for the asymptomatic, because effective and safe screening requires stringent conditions which are rarely met except in a handful of conditions with careful planning. Now, the wisdom is that screening is so simple that even a child can test themselves under home conditions. It is considered good practice if a million healthy people are quarantined unnecessarily through this £33 billion screening programme (from whose planning the actual UK screening service was excluded).
- Quarantining the healthy was never even considered in the past, and the WHO pandemic guidelines specifically excluded it as useless and harmful, except perhaps for high-risk contacts entering a non-infected new population. Now, when the virus is ubiquitous, the whole world gets quarantined even if it causes economic meltdown and deaths from starvation, with no clear benefit in curtailing infections.
- Death certificates used to be intended both to inform relatives of the deceased regarding true causation, and to improve epidemiological knowledge. Since 2020 they have instead been used to maximise the number of deaths attributed to COVID-19, often treating a mere suspicion of an associated condition as the certified cause of death.
- In my day, post mortems were an important way of learning about new diseases, not least to differentiate them from other similar ailments. Across the world they were banned for COVID, apparently on grounds of safety.
- The vocation of medicine used to include the acceptance of personal risk as a matter of course. I remember being pushed into a room with a violent patient by the policemen who had barricaded the door from the outside, and it all went very well, fortunately. Many health workers put this noble principle into practice with COVID, and a few paid with their lives, largely because facilities and training for managing infectious diseases has been so run-down of late, and probably also because the doctors became run-down as a result – anxiety disorders are the second commonest predictor of poor outcomes in COVID, according to the CDC. But apart from these acute-care staff, the NHS has more or less shut up shop for 18 months, and many (vaccinated) doctors even now refuse to see patients in person – which appears to be because the NHS itself criticises them if they do. I, on the other hand, was still influenced by the image of the doctor taking personal risk in his stride at the bedside of a dying, infectious child. And I survived, as did most of us.
- I was taught Koch’s postulates for linking a particular pathogen to a particular infection irrefutably. It appears that for many decades they have proved impossible to implement with virus infections. The result is that in few of these conditions is there a clear “evidence chain” to characterise and isolate a virus and demonstrate its pathogenicity. It has all become a matter of indirect inferences. SARS-CoV-2 has never been isolated from patient swabs, blood samples or treated tissue cultures, and hence never definitively sequenced, nor definitively photographed, nor definitively linked to the disease COVID-19 (which is circularly defined by the result of the test for it). And so every diagnostic and therapeutic intervention for the disease is an inference built on inferences. The whole pandemic is therefore a probabilistic exercise, much as infectious diseases were before Robert Koch – hooray for progress.
- In my day, most susceptible people caught a disease and gained lifelong immunity. But the value of natural immunity, cell-mediated immunity and cross-immunity to other Coronaviruses is now effectively denied, even now that SARS-CoV-2 is clearly endemic. Only vaccination counts towards immunity, even though the mRNA vaccines are, apparently waning not only in their antibody responses but in their protective effects after just a few months.
- Related to this, even the most foolish doctor knew that immunity from infection is always far better than that from vaccines: all vaccines have a failure rate, whereas it is extremely uncommon to get, say, the old childhood diseases a second time. The aim of vaccines was to get adequate immunity with fewer symptoms. Now, on no evidence whatsoever, even leading government- and industry-financed doctors claim that only vaccination gives useful immunity at all. This despite the majority of the world’s population escaping significant disease and acquiring antibodies naturally over the last 2 years, whilst unvaccinated. “Vaccines better” is also a surprising claim when mRNA vaccines target only three short RNA sequences, which easily mutate, rather than the whole virus. It’s not yet clear to me, at least, to what extent effective cell-mediated immunity to wild virus occurs after vaccination, even before the virus select for resistant strains.
- Oh, and the idea of mass-vaccination during a pandemic became a clear non-starter as soon as the possibility of developing vaccines that quickly began to emerge. Maximum viral activity + minimum patient immunity + vaccinating the whole world is bound to maximise the selective pressure on the virus to develop resistance. But Bill Gates assured us early on that only vaccinating the whole world regularly would get things back to normal, and he’s an expert.
- Then I learned in immunology, way back in pre-clinical, about IgA, IgE, IgG, IgM, B-cell immunity and T-cell immunity, and their different roles and time-courses. The easiest antibody-titres for blood samples were IgG, which I used occasionally in general practice, being fully aware that antibodies would develop over weeks and gradually diminish because that’s what circulating antibodies do. But in COVID, IgG has suddenly become “The Immunity Test,” its level telling you how immune the patient is and its absence that they are susceptible. This new wisdom overturns my entire immunology training. Because the vaccine is injected and (contrary to the original claims of the developers) is circulated to organs via the bloodstream, its ability to produce IgA on mucous membrane is limited, which probably explains partly why one can still catch COVID after two vaccinations – Ivermectin and even Vitamin D seem to be more aptly targeted at the problem.
- When I was in practice, every intervention was implicitly, or more often explicitly, provided with informed consent as to known benefits and risks. I was aware that pharmaceutical corporations were often not to be trusted, and hence I was usually hesitant to use new drugs, especially when they were heavily marketed. My gut feelings often proved right as “flavour of the month” drugs like Opren and Vioxx were withdrawn, and others which were self-evidently useless, like Tamiflu, went out of fashion. Along the way although busy GPs, sad to say, seldom have time or critical skills to read the original research produced by Big Pharma in support of their wares, I was taught by an excellent Professor of therapeutics how to critique even prestigious studies that didn’t show what they were purported to show. But now mRNA innoculations, whose predecessors were all withdrawn at the animal testing stage, and which are now granted emergency authorisation for Phase 3 and 4 trials on the public without controls or adequate follow-up except through the Yellow Card scheme and its foreign equivalents, are pronounced by official medical sources to be “safe,” whatever that may mean in a scientific setting. Funnily enough, Bill Gates was saying they were safe before they were even developed, so who needs medical qualifications or long-term trials?
- Whilst on vaccines, it went without saying back in the day that vaccination is a social contract, in which one personally benefits from protection, one benefits the community through herd immunity, and one shares the inevitable risks (historically small) of the vaccines themselves. The selfish, or canny, person pushed mass vaccination but avoided it himself, thus benefiting from herd immunity without personal risk. But now, those at little risk are expected – and against all ethical precedent sometimes coerced, threatened or bribed – to shoulder the considerable risks of novel and incompletely-assessed vaccines solely for the benefit of others. This is a novel and dangerous form of social contract, which in this case puts children at risk for the elderly.
- The Yellow Card scheme was always an under-utilised first-alert system for, particularly, new drugs. I was probably keener than most GPs in returning them, and no doubt it was reports like those from around the country that began to draw attention to problems with Opren, Vioxx and of course the H1N1 vaccine of 2009, GSK’s Pandemrix, which caused narcolepsy in hundreds of young children, only discovered a year into its use. Now, it seems that because Yellow Cards do not actually prove causation of side effects, the vaccines may be rolled out to a wider and wider range of un-researched groups. in the knowledge that all the reported deaths and complications are coincidental. Because, you see, vaccines are safe. Except when they’re not.
- Then there are masks. I first used them whilst observing operations in theatre at Westminster Hospital – those disposable ones now sold to the public to be used until filthy and then dropped in the street. Once I started to assist at operations, proper sterile tied surgical masks were traditional to prevent dribbling bacteria into open bodies, and by extension were also used in minor surgery (though gloves were not always employed in that setting if scrubbing up was done properly). We didn’t know then that studies would show no increase in wound infections either from unmasked surgeons or unmasked students standing round. At the time the AIDS scare took off, nurses started to use gloves and disposable masks for routine procedures, in the mistaken belief that AIDS is highly contagious, and that too became a customary ritual, so that nowadays even care workers and retail butchers use latex gloves because… body fluids.
Every now and then I’d come across cloth masks left over from yesteryear in an old cupboard, but of course nobody believed they were of any use whatsoever by the time I reached medical school in 1973. But now it’s all different. Despite the WHO guidelines as late as 2019, and despite the Danish double-blind mask-study of 2020, and despite the lack of any discernible effect of mask mandates on mortality in any country, we now know that the politically-motivated decision of the WHO to recommend masks makes a home-made cloth mask kept in the pocket, a bandana or a welder’s visor an effective protection against viral aerosols. Back in my day, comparing single-use N95 masks in hospitals with cloth masks would have seemed like saying that because sterile surgical gowns lessen wound infection, a dirty T-shirt and Levis will as well. I’m not sure Semmelweis, Pasteur or Koch would have agreed, but that was the Olden Days.
- Lastly, there used to be a medical press full of conflicting views about diseases and their treatments. I don’t only mean at the academic level – we GPs got weeklies like Pulse and Doctor, fortnightlies like World Medicine or monthlies like The Physician, most of which I wrote for, and all of which had lively correspondence pages where experienced practitioners exchanged orthodox, and quite often heterodox, opinions. In this way the profession was kept diverse, inclusive, vibrant and self-critical both scientifically and ethically. Now, doctors lose their jobs simply for signing the Great Barrington Declaration.
Consequently, I suspect that nowadays I would be so fearful of voicing any unacceptable views in a GMC revalidation test that I would self-censor myself into silence, and be struck off anyway. So that’s how Cambridge University medical degrees turn into quackery!