A Noted Physician Advocates COVID Civil Disobedience

We can regain our medical freedom by being more than in Thoreau's words “straw or a lump of dirt.”

Famously, at the start of his 1849 essay, “On the Duty of Civil Disobedience,” Henry David Thoreau observed, “That government is best which governs least.”

Few policymakers or politicians during COVID were influenced by Thoreau, who also pointed out that “government never furthered any enterprise, but by the alacrity with which it got of its way.”  Did government mandates and lockdowns make us safer or less safe during COVID? Healthier or less healthy?

Thoreau defined the “right of revolution” as “the right to refuse allegiance to, and to resist, the government, when its tyranny or its inefficiency are great and unendurable.”

Dr. Vinay Prasad is a practicing oncologist and a professor of epidemiology and biostatistics at the University of California, San Francisco. He is one of the foremost practitioners of evidence-based medicine in the world. He believes the time has come to “refuse allegiance” and “resist” the COVID bureaucracy, which resorts to lies. 

To those who justify irrational policies such as masking a toddler, Prasad writes, “Just because things are bad, or the disease is worse than the intervention, doesn’t mean the intervention helps, or should be done.” Prasad is bringing Frédéric Bastiat’s classic idea to medicine: Do not ignore consequences.

Prasad has become increasingly disturbed at policies made for political, not medical, reasons. Recently, responding to a report that N-95 masks are being mandated for children enrolled at a Montgomery County school, in Maryland (a suburb of DC), Prasad wrote, “Only non-violent resistance can halt irrational public health actors.” At this point, note that the original title of Thoreau’s essay was “Resistance to Civil Government.”

The following are the forms of non-violent resistance Prasad recommends: Even if you or your child are sick, do not test for COVID. Send your child back to school when he is well enough. “Stop reporting these illnesses” to schools and employers. “Complain to your employer about any mandates.”  “Decline any further COVID-19 vaccination, unless RCTs [randomized controlled trials] show benefit in your age group.” 

In short, ignore authorities; they don’t have your best interests in mind. Prasad adds that this resistance “is the only logical course left… It’s time to go dark with all COVID data. If enough people don’t participate, the irrationality will stop. Eventually.”

If Prasad had advocated this in 2020 or 2021, he may have found his board certification subject to disciplinary hearings. But this is 2023, and despite censorship, evidence is mounting, and the intellectual climate is changing. 

Isn’t all medicine evidence-based medicine? Dr Prasad would answer, if only. In 2015, with his colleague Dr. Adam Cifu, Prasad wrote Ending Medical Reversal. Prasad and Cifu observed:

Medicine is the application of science. When a scientific theory is disproved, it should happen in a lab or in the equivalent place in clinical science, the controlled clinical trial. It should not be disproved in the world of clinical medicine, where millions of people may have already been exposed to an ineffective, or perhaps even harmful, treatment.

In their book, Prasad and Cifu wrote, “Each of us recalls moments when we realized that what we had told our patients, or did for them, was wrong: We had promoted an accepted practice that was, at best, ineffective.” Notice the use of the qualifier “at best,” as often interventions are harmful.

Prasad and Cifu estimated “as much as 40 percent of the things doctors do are ineffective.” They give many examples, such as estrogen replacement for postmenopausal women and medical procedures such as “stenting open coronary lesions in people with stable angina.”

If you watch television, you have probably seen the incessant Pfizer ads promoting their COVID treatment drug, Paxlovid. Yet, Dr. Prasad tells us, that despite the Biden administration’s pushing and subsidizing the drug, there is little evidence that the drug works. 

Even without cronyism showing the way, ineffective and dangerous drugs are not uncommon in the annals of medicine. Until 1992, the drug flecainide was part of the standard of care to stabilize patients with irregular heart rhythms. Prasad and Cifu reported, “a large study called the Cardiac Arrhythmia Suppression Trial (or CAST trial) showed that flecainide, as well as a similar drug, decreased PVCs as expected but also increased patients’ chance of dying.” (emphasis added.)

Prasad and Cifu drew the essential conclusion that “even the most careful reasoning and the best scientific models do not guarantee an effective clinical treatment. What works in the lab, or on a computer, or in the head of the smartest researcher does not always work in a patient.” 

Yet Prasad and Cifu acknowledge, “this is a lesson that many physicians and leading researchers still have not really learned.” Lack of learning contributed mightily to the devastating policy errors during COVID. 

Writing years before COVID, Prasad and Cifu observed, “What has happened in medicine is that the hypothesized treatment is often instituted in millions of people, and billions of dollars are spent, before adequate research is done.” During the pandemic, necessary economic tripwires were disabled when vaccine manufacturers were indemnified from liability for harm caused by their products. 

Prasad and Cifu provide timeless insights into why ineffective and dangerous treatments persist without “a strong evidence base.” They observe, “The weak evidence base is often ignored because of doctors’ faith in mechanistic explanations or studies that were designed to be deceptive by industry.”

Prasad and Cifu described the “act now, data later” mindset so common in medicine and in life today: “We have a problem; we need a solution. We hear the mantra every day. We need to solve this problem now. Ten minutes ago. Yesterday. It is not just in medicine but everywhere.”  This mindset, adopted by millions of Americans, is behind every ill-conceived practice instituted during COVID and also behind the increasingly destructive rush to “green energy.”

Reversing errors is not easy. Prasad and Cifu explained,

It is very hard to accept evidence that something you have done for patients, something that you truly believed was beneficial, is not useful. The evidence is even harder to accept when you have been well compensated for your work. Because of this, acceptance of medical reversals is never easy and opposition to them is usually passionate.

Thus, the medical administrative state won’t easily change. Yet, Thoreau asserted, government “can have no pure right over my person and property but what I concede to it.” We have conceded too much. With our concessions, we have lost our humanity. In Thoreau’s words,

The mass of men serve the state… not as men mainly, but as machines, with their bodies… In most cases there is no free exercise whatever of the judgment or of the moral sense; but they put themselves on a level with wood and earth and stones; and wooden men can perhaps be manufactured that will serve the purpose as well. Such command no more respect than men of straw or a lump of dirt. They have the same sort of worth only as horses and dogs.

We can regain our medical freedom by being more than “straw or a lump of dirt.” We can expand our comfort zone to go against the herd. The time is now to resist pressure from friends and family and to stop obeying authorities. Non-violent resistance is a viable recourse.

This essay was originally published at the American Institute for Economic Research.