Thread by @alexandrosM

Welcome to the "making sense of the 'making sense podcast' thread."🧵

Let's listen together to Episode #256 (A Contagion of Bad Ideas: A Conversation with Eric Topol)

The whole podcast is unpaywalled on YouTube:

We'll follow the flow of the podcast.

Sam Harris is someone I have a lot of respect for, though he's lost my attention recently, as it seems the last few years he's no longer setting the agenda, moreso trying to keep up.

This podcast touches on issues I've written a lot about so I want to see how it holds up.

I struggled with whether to do a thread now, or do a challenge like we are doing on @BetterSkeptics for the DarkHorse Podcast. What pushed me over the edge is that Sam's podcast is already being fact checked left and right so by the time we can do a challenge, it may be too late.

Sam starts the "PSA" podcast by talking about people who don't feel COVID is such a big deal or it's a hoax, but concerned with the vaccines. I'm sure these people exist, but I don't have much exposure to them. Then he talks about his "side" which thinks the opposite.

Since much of this is devoted to Bret Weinstein & guests, it's a strange start, as Bret is the one I've seen be most worried about the virus. The earliest DarkHorse episodes were detailing the excruciating process of getting into his car when surface transmission was a worry.

Sam tells us that he doesn't think talking down or casting "the other side" as stupid works. This is a good sign and hopefully we'll finally get a serious discussion on the merits.

Sam feels that "those of us who are vaccinated" ... "have been pushed back into that tunnel by, frankly, the confusion of our neighbors". Is he blaming the delta variant on the unvaccinated? To my knowledge this is not a straightforward claim, and likely false. Other views here?

In the restaurant story around 5 minutes in, Sam assumes that noone who doesn't need to wear a mask would wear it, even staff at a restaurant. I hate to break it to him but I wear a mask inside even if I'm double vaccinated and the store doesn't ask. I guess he'd judge me for it.

He takes this assumption and adds another: "there is no reason these guys aren't vaccinated". Putting aside the fact he doesn't know that, isn't there a chance they may have had COVID, and therefore be enjoying what seems like possibly superior immunity? healthline.com/health-news/ne…

"...but for the fact that they have some spurious memes and bad ideas bouncing around their brains". If I've not lost count, this is the third assumption Sam is building on what is an increasingly shaky Jenga tower of assumptions.

"they were very likely put there by some of my friends", "podcasters who have gone down this rabbit hole themselves, or just platformed people who spread misinformation about vaccines". It's pretty clear who we're talking about, yes? "and not known enough to push back". Really?

Sam continues what is starting to sound like the internal monologue of a person who is broken by paranoia. Not only are these waiters "podcast listeners, he knows", since he considers that "mask=no vaccine", he considers that the masks themselves are an ad for vaccine hesitancy.

"They are advertising it on their faces by wearing masks that would otherwise be unnecessary for them". Sam -- you don't know this. You're already far from home, and this is minute 6. How long is this thread going to be?

"The goal of today's podcast is to present a very simple case which ... stands a chance of persuading some of the vaccine hesitant". He makes a crisp case:

Even if you think the worst of the vaccines, given how bad covid is, and how effective the vaccines are, still #worthit.

It's good to have a clear-cut case with which to judge the content we're about to listen to, and Sam is one of the clearest speakers when he wants to. He doesn't disappoint us here, and it's credit to his intellectual honesty and good manners that he makes his case clear.

I have to remark on how he says "one of the largest medical experiments ever performed" with an implication that we're supposed to be admiring it. I also advocated for fast vaccine rollout last year, but I would not use those words in that order. It's strange he doesn't see it.

Sam seems to be presenting this podcast as material to send to the vaccine hesitant as he introduces Dr Eric Topol. "He's been very active on Twitter, countering some of the crazy ideas that have been spread". Since Sam doesn't seem to draw a distinction, it must be said that ...

...Eric Topol has been on what seems to be the wrong side of the Lab Leak hypothesis from the start. He's been applauding Daszak, and even cheered Dan Rather in this tirade:

https://twitter.com/EricTopol/status/1406631952736677895?s=20

I had written about how ignorant media personalities responded to Jon Steward flipping the narrative on them out of nowhere at the time, and it's not a surprise to see Topol egging them on, even though they distort the very meaning of science.

https://twitter.com/alexandrosM/status/1406825580901765128?s=20

Speaking of distorting science, Eric Topol is the boss of one Dr Kristian Andersen. You may remember Kristian from such hits as "incompatible with the predictions of evolutionary theory" and "crackpot, fringe theories".

https://twitter.com/alexandrosM/status/1400868297797636104?s=20

"Neither I nor Eric have any conceivable conflict of interest". Really? Not even conceivable?

"Neither of us have an idealized picture of the pharmaceutical industry, or the incentives that might drive any specific decision there".

Sounds good. Finally we're over the intro.

We're promised a case "starting from first principles and what we can be *sure* of in the current environment".

On paper, this sounds great but is an incredibly high standard that I've rarely if ever heard scientists hit. I'll try to set aside my skepticism and listen for it.

Topol comes in strong: "The vaccine progression ... to rolling out vaccines all in a matter of months" .. "one of the greatest triumphs". He may very well believe this.

I can't for the life of me imagine why, however, in a podcast that's purportedly intended for the hesitant, he'd be triumphalist about completing everything in months, when that's one of the main issues raised by the hesitant. Sam raises how everyone is siloed, a strong point.

Topol steps in, as if to prove Sam's point: "it's not as if the smokers are trying to harm the non-smokers". So we're saying the unvaccinated are *trying to harm* others? You may say this is literary twist, but in that case, yes, the smokers give others 2nd hand smoke too. So...

"It's a flip of the model"... "the majority would help the smaller one"... "we have a much more contagious virus" ... "that's not the way it was supposed to work". Topol seems to be surprised by the virus evolving. This does not confidence in an expert create.

Sam steps in to try to steer the ship in the direction he set out to. "This is a pointless exercise if we can't say something that stands a chance of being persuasive". This is quite sad for me as Sam Harris used to be about discussion, listening, making sense. Now? "persuasion".

Very much like christian rock, the music may be good, but the art is compromised when you've written the bottom line before you start exploring. Sam has already drawn his case, and he'll try to extract it from Topol who seems more interested in easy jabs. No pun intended.

Now, if you are trying to reach out to the hesitant, which by this point in the podcast we've established have a political bent, do you bring on this guy? I mean, just on sheer strategy.

https://twitter.com/EricTopol/status/1349563677041598464?s=19

Topol: "A lot of this is purposeful, ... intentionally trying to prevent the benefit from being actualized". then continues with the bridgebuilding by citing this cartoon:

I don't know if this is incompetence or malice on Sam's behalf, but I don't have him for the malicious kind. He wants to address this PSA podcast to the hesitant, which he tells us lean heavily republican, and has this person on, who comes off as a political hack.

And then, I kid you not, he brings up the russians. At this point, are any Trump supporters even continuing to listen? We then continue talking about the "covid is a hoax/overstated" crowd. We then smoothly shift to ivermectin advocacy, and somehow it being part of a conspiracy.

Let's get back to basics. The people who think covid is a hoax, or a conspiracy, or overstated, are not beating down the doors for ivermectin, to my knowledge. Sam has managed, in a few words, to transition to a completely different group of people, while mentioning conspiracies.

This is starting to remind me of a certain article on the Quillette of all places, connecting ivermectin with people hypothesizing massive conspiracies. If for whatever reason you haven't read my thread on that, here it is:

https://twitter.com/alexandrosM/status/1412814554510200832?s=20

Topol continues saying that Delta variant indicates a small drop in effectiveness, down to 88-90%. We have very new data, that perhaps Dr Topol was not aware of, but for the sake of informing ourselves:

https://twitter.com/jonatanpallesen/status/1418829400699723788?s=20

I was puzzled by Topol saying that Israel had vaccinated 89% of adults. I think he may have been slightly confused, as at the time he was doing this the number was closer to 85%, but it's close enough and I'll grant the point. I am quite surprised. deseret.com/coronavirus/20…

Next up, we are getting into VAERS data. Topol says "they have no idea whether the death has any linkage" ... "unadjudicated data". In the same passage, he accuses people of misunderstanding this data purposefully, twice. Let's get this straight.

The fact that "they have no idea", is not a good thing. That fact should be worrying us. Yes, there is a baseline expected rate of death, but we can calculate what that is, so why isn't the good doctor telling us what it is? It really feels we're celebrating incompetence.

Sam then continues to say "even if we took the VAERS data at face value, even if we acknowledge that 12,000 people have been killed outright". Sam should have quit while he was ahead. The number in VAERS is not claimed complete by anyone to my knowledge. I don't want to scare...

...anyone, but due to the incredible amount of confusion that has been allowed to grow due to the terrible UI/UX of VAERS, the fear is that there is an order of magnitude undercounting in the numbers. Of course this isn't causation, but at those levels, you run out of options.

Topol slides from saying that the VAERS data cannot be used to determine anything, which is a position that can be understood, to saying that his conclusions on safety "can't be questioned". When it comes to marketing to the hesitant, this isn't it. Seriously.

"that's the most solid evidence dataset that I've known in my 35 years in academics". Anyone have any idea what he's talking about here?

"In the history of vaccines, there has never been something that showed up, beyond 2 months, after the vaccines were in common use". Is he comparing conventional vaccines here with adenovirus / mRNA vaccines? I can't imagine what else he could be doing.

So let's have the talk. When you're making such leaps, you're gambling with something more important than COVID. You're hitching the brand of "vaccines" to these new tools, that for all we know may turn out amazing, but are substantially different. If it works, ok. If not?

In the unlikely case, and one I sincerely, for the good of our civilization, hope never occurs, that there is some long-term side-effect of these new vaccines, we have blown up the entire edifice of vaccination. We didn't have to bring its credibility into the mix. But we do.

In my opinion this should be only ever done carefully, and with appropriate qualifiers. Topol here throws caution to the wind to land a zinger. I have a few words for him:

https://twitter.com/alexandrosM/status/1416392727286095873?s=20

Dr Eric Topol: "there's no reason to think that these vaccines are going to be different than vaccines that have been going on for many, many decades". Why overstate your case here? This is incredibly irresponsible, bordering on actual misinformation.

Topol moves in for the kill: "I saw this through commentary that Bret Weinstein put out that people who get a headache as a side-effect of a COVID vaccine, which is not uncommon, to get a headache, that that could be brainfog from the mRNA getting into the brain."...

..."this is totally unsubstantiated. totally". I have good news and bad news here. The good news is that Topol is telling us that this is unsubstantiated. The bad news is that he doesn't mean his own quote. So what *does* he mean? I haven't ever heard this quote, so I googled.

Best I found is this tweet on brainfog & headaches. But of course it says nothing like what Topol misconstrues above. Not only is it not OK to accuse this way, but Topol is creating novel memes and putting them in the mouth of someone many people respect.

https://twitter.com/BretWeinstein/status/1408479771957153796?s=20

Topol: "For anyone to posit, that people who get a headache, is having mRNA going into their brain, that is totally irresponsible". Indeed. Totally irresponsible Dr Topol.

"reckless", "sick", "unnecessary doubts", "these people, the innocent", "it's predatory", "it's taking people who want to believe in a conspiracy, or don't know what to believe, and making vaccines look like they're intended to harm, with no evidence whatsoever". Self-commentary?

Seriously though. Who is positing conspiracies, ranging from the far-right to the yoga moms, to the podcast watching waiters, all reading tweets from Bret Weinstein, and simultaneously not caring about COVID but freaking out about the vaccine? Who believes this fabulism?

What is happening in reality, and it's not helpful to the story being painted, is that Bret and Heather have a very low risk tolerance. Long-term viewers remember them saying they are careful with the fish they eat due to fukushima. They sleep apart when one is ill.

They follow extreme, to most of us, precautions, *in general*. This is why throwing in the spurious "covid is a hoax / overstated" meme is so potent. Because in light of this lie, which Sam maybe is not aware is a lie, the whole interpretation of their words pivots.

Sam then essentially endorses the fact that over-vaccination is a profit motive for pfizer, which Bret agrees with, and I, for once, stand apart from both of them, needing further evidence, like a good little capitalist:

https://twitter.com/alexandrosM/status/1413725713501327364?s=20

After a crescendo of emotive conjugations from Sam, saying things they essentially all agree with, but with scare quotes every other word, they get to the EUA. This is critical and needs attention:

Topol: "The notion about the EUA is incorrect. Firstly, that is, the definition, in the setting of a pandemic or a crisis for the FDA, is, 'may be effective'. That's all it takes. It doesn't have to be that there's no other treatment. As long as it's effective in an emergency"

I may be missing something here. Topol uses a qualifier "in a pandemic or a crisis", which does not show up in the guidance. fda.gov/regulatory-inf…

What appears:

"For FDA to issue an EUA, there must be no adequate, approved, and available alternative to the candidate product"

He then mentions EUAs for other things granted before the vaccine. I'm confused as to why this is an argument, as the different EUAs don't seem to contradict each other. What you don't want is an approved treatment. Oddly, this might actually present a refutation of the ...

...argument that Bret is making, though I'm not a lawyer (and I am not an MD either btw, so don't follow the advice I'm not giving you). If EUAs don't conflict, but only approval of a drug for a specific use voids competing EUAs, then an EUA for ivermectin for Covid should be ok.

This is not the argument Topol is making. He can't stop giggling long enough. This is a suspicion I'm developing hearing all this and reading a little through the lines, but it's falsifiable. Any lawyers in the house?

Topol mentions that convalescent plasma and polyclonal antibodies may have brought on "all these variants". Does anyone know what he's talking about? And does Sam realize that if Topol is right he's out a whipping boy in the unvaccinated that he blames for Delta?

Then, we get to ivermectin. Standard fare arguments. Small trials, anti-parasitic. Look at the one meta-analysis I like and not the others. My friends are unbiased. Of course. But he does grant there may be real signal there in the data, and that it's relatively safe. Good

Then Topol names criticisms of the Elgazzar study that I have not dug into, but given his liberal relationship to the truth, I can't really tell if they are real. If anyone has looked into those specific claims, please let me know.

[We're at 55:40 btw, it you're syncing.]

Topol though admits that there's a signal, but also is almost laughing at the size of the studies. Has Dr Topol advocated for large-scale trials of ivermectin? If not, why not? How does it make sense to say there's probably signal, but not be beating the "large studies now" drum?

Then, something curious. Topol quotes the words "99% effective". This is truly curious, because Bret, to my knowledge, has never said those words. They've been put in his mouth, though. Where? In the garbage Quillette article. Is Dr Topol and Sam Harris getting their info there?

Sam then applies to the "pander/smash" strategy, as used by William Lane Craig in his debate with Christopher Hitchens. Say nice things about your target, before you move in for the kill. "dangerous. frank misinformation. getting pushed out to millions and millions of people"

Then Sam proceeds to presume what animates Bret. There are hints of mind-reading throughout, but it's now overt. In my mind, when you proceed to presume your opponent's internal mental state, you've automatically lost the argument. It's a bad habit of mind, and noone should do it

Topol then moves on to some bizarre argument that I'd love to have explained to me. Best I can tell, he is unhappy that the lab leak hypothesis got legitimacy, because people he didn't like were right. (Like Bret).

Then, they bring up the podcast with Tess Lawrie. Perhaps one of the poorest quality arguments yet. "He looks like an intelligent fella - but he shouldn't be passing himself off as an expert". What was Dr Tess Lawrie doing there Dr Topol? Invisible like Dr Heying in all this?

And then a double whammy. "The Dr Kirsch". Kirsch is not a doctor. And to my knowledge, he did not claim vaccines have "caused" anything, as claimed here. One more time Dr Topol creates new memes that were carefully avoided until now by the "irresponsibles" he's talking about.

They then bring up the emergency podcast with Joe Rogan. They mention things that have not been said, like "99% effective", and some actual 2-word clippings. I challenge anyone to sound good if others are allowed to pick random word-pairs from their speech, for effect. Balderdash

Topol: "This is one of the chief offenders. It's Dr. Malone who puts out that he is the inventor of the mRNA vaccines. Guess what? He wasn't the inventor, and what he does, he is now the person who is leading the charge against the vaccines. And people unknowingly, because he..."

"...identifies himself as the inventor, this is the perfect fuel for the conspiracy, it's incredible, you can't make this stuff up, the person who positions himself as the inventor, having worked decades ago, on a path, but he is not the inventor of either of the mRNA vaccines"

Yes, ok! Fine! He isn't. And you, Dr Topol, are not the inventor of twitter! Wait, what, we're not just accusing people of not inventing things they didn't claim to invent? No? Oh. Well, then. Dr Malone claims to have invented the mRNA vaccine technology.

And you know what, I looked it up, and far as I can tell, his claim is as strong as anyone's. If Edison invented the lightbulb, then Dr Malone, with >50% confidence, invented the mRNA vaccine. Receipts:

https://twitter.com/alexandrosM/status/1415218732033482756?s=20

I still need to clean it up, but it will have to do.

And then, in perhaps the most serious misstep yet, Dr Topol accuses the "frontline doctors, one of whom was part of this" of having sued the US Government to take the vaccines off the market. This here requires a little... unpacking.

Dr Topol most likely is referring to this lawsuit. gizmodo.com/pro-trump-grou…

But what is this "one of whom was part of this"? He couldn't possibly be confusing the FLCCC with the AFD and tarring Dr Pierre Kory and Bret Weinstein, could he? Just because of a single word in common?

Dr Topol, has moved on to full-on projection mode:

"Stick with the facts. Don't make stuff up"

Yup. Do stick with the facts. Please.

**something something Berenson something something**

The jenga tower is now complete. Sam is ready to pull out the one big piece from the base, and bring it all tumbling down. Wait for it...

Sam then, talks, I suppose from experience, about how... "you can always find a crackpot PhD or MD, for any, you can find them to defend big tobacco, either cynically or based on derangement, will back a cause, and put their credentials to that purpose".

Topol:"If we had a counteroffensive, for the facts, remember when Trump was very frequently lying and there was a fella on CNN that was the official fact checker, and he would take them on one-by-one, and get the facts, he did an exceptional job I have to say, he was pretty busy"

Sam: "20,000 documented lies I think?"

Topol: "Anyway, we don't have that in the pandemic. If people were called out for lying, they might back off. But they don't have a license to just make stuff up. Or twist things, you know?"

HELOOOO!! I'M HEEEREEE!!! CAN YOU HEAR ME??

***psychologizing intensifies***

Topol drawing emotional context from how it felt to be in a close-knit fellowship with Daszak, Andersen, Holmes, and the gang, conspiring to suppress the lab leak. Good times.

Sam: "People who have a conspiratorial style of explaining anomalies don't tend to recognize that their explanations don't actually run through, I mean there's no plausible background set of incentives to explain a given conspiracy coming together".

Right, Sam. Yeap.

Basically Sam is convinced that Bret is positing a conspiracy, which, to my knowledge, Bret has never done. But it has been put in his mouth. Where? Quillette, of course.

Topol, in a strange turn of events, makes me cheer for Merck, almost ending his career. Why "almost" guys?

Then they pivot to the full aproval of the vaccines by the FDA. Topol criticizes them for being too slow. He wrote an op-ed he says. Not like the op-eds he used to write before the elections, criticizing them for being too fast. No, that was another time, another president.

Sam: "The truth is, we need institutions we can rely on, and it's pretty clear we don't quite have them. The FDA, the WHO, the CDC, all of them have, in various moments, covered themselves in embarrassment, in the last 18 months..."

"...There's a rational way to understand that, and there's a paranoid way to exaggerate the [?] of that problem."

Paranoid. Did I mention he brought up the baseline schizophrenia rate in the general population? Not realizing the argument cuts both ways?

Sam Harris. Calling people he disagrees with paranoid and schizophrenics. Paragon of rationality himself.

Topol: "Maybe, after all this we'll have a movement to being data-driven, evicence based, and not allow for misinformation to propagate."

Dr Topol, you can start today!

That concludes this episode of making (no) sense with Sam Harris. Thank you for joining us. The time is 4:42 AM and you are you?
= FIN =

...Phew. Ok, this was epic. Send me any other inaccuracies and distortions I missed, and I will add them to the bottom of this thread. Also,

I've added this thread to my 🧵🧵related to the ivermectin wars of 2021:

https://twitter.com/alexandrosM/status/1413977110180364294