Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
I'd like to thank revere right now publicly. He's taught me a new word:
Methodolatry: The profane worship of the randomized clinical trial as the only valid method of investigation.
Many of my readers have e-mailed me about a recent article in The Atlantic by Shannon Brownlee and Jeanne Lenzer, two reporters whose particular bias is that we as a nation are "over treated." That may be true, although not to the extent that Brownlee, at least, seems to think, and her article on swine flu was truly execrable. Moreover, "methodalatry" perfectly describes one of my complaints about the "evidence-based medicine" paradigm. So I'm really glad that revere took it on and demolished it.
I had actually planned on blogging about this article. However, it's a long article, with many, many shortcomings. The whole Suzanne Somers thing seemed to take on a life of its own and crowd out my chance at blogging the Brownlee article. I may have to rectify that situation for Monday. revere covered a lot, but he didn't cover one aspect of the article that bothered me even more in as much detail as I want to. On the other hand, he made my task easier by covering a lot of the issues of vaccine efficacy. Stay tuned.
In the meantime, you might also want to read Mark Crislip's article on flu vaccine efficacy, which, although not directly written in response to Brownlee's article, does address many of the shortcomings in its analysis of H1N1 vaccine efficacy.
Medicine & Health
Comments
Obama declares swine flu national emergency
Order could speed up treatments by waiving certain medical standards
The insanity escalates
Posted by: Sid Offit | October 24, 2009 2:05 PM
Your insanity, Sid, yes.
Posted by: smaller | October 24, 2009 2:47 PM
Smaller. That's an approprite name
Posted by: Sid Offit | October 24, 2009 3:04 PM
Yeah Sid I'm really worried about them bypassing the rules for setting up alternative medical sites in places like schools or the hospital parking lot.
Posted by: Adam_Y | October 24, 2009 3:50 PM
What's that, Sid? I can't see it when people don't use punctuation type.
Posted by: smaller | October 24, 2009 8:49 PM
I can, however, see posts that forget to use relative pronouns just fine.
Posted by: smaller | October 24, 2009 8:52 PM
Sounds like he's been cribbing from Kevin Champagne again. Remember how KC was all freaked out about Giving! Vaccines! In! Grocery! Stores! last week?
Posted by: Phoenix Woman | October 25, 2009 12:17 PM
Dear Sid:
Hospitals can't open additional emergency rooms if they wish to treat the spike in flu patients off-site (the very real spike, Sid, just talk to our local ambulance drivers)without this declaration. They also can't increase the number of beds available for the increased number of people requiring hospitalization (we now have in our mostly rural area six people on ventilators due to H1N1. That's one-third of the ventilators in the county).
Can you provide us your address, Sid? I'd like to mail you a dollar so you can go buy yourself a clue.
Posted by: Shay | October 27, 2009 2:33 PM
Lest anyone conclude that the august Atlantic has lost it completely, what with hiring McArdle and running the Brownlee / Lenzer piece, let me point out that you can also go to theatlantic.com and find this.
Posted by: jre | October 27, 2009 2:45 PM
Today I went to my primary care physician for a regular checkup. There is no H1N1 vaccine available. I inquired about getting the pneumonia vaccine and was told that I didn't fit the recommended target population. I explained that I would like to at least be protected against some complications of the flu if the H1N1 vaccine was not available. Still, no go on the pneumonia vaccine, just a recital of the recommended targets for pneumovax.
I'm a bit taken aback by the refusal to vaccinate me against pneumonia. I'm well sold on vaccination in general. Now I'm just shaking my head and wondering if vaccinating against polio is still reasonable, how in the heck is it not reasonable to give a vaccine for pneumonia?
If anyone has any thoughts on the matter and is willing to share, I'd appreciate it. I'm still considering trying to get the pneumonia vaccine at the local pharmacy but wonder if I'm missing some major error in my thought process here.
Posted by: Jane | October 28, 2009 8:46 PM
Jane, I'm not an expert, but I do have some thoughts on the matter. I don't believe it's possible to vaccinate against pneumonia-the-condition - it's only possible to prepare the immune system with antibodies against one specific bacterium that causes pneumonia. So if you got vaccinated against that bacterium but then got the H1N1 flu, that vaccination wouldn't prevent you from getting pneumonia as a side-effect of the flu.
That's my understanding, anyways, and I hope someone will speak up if I'm dreadfully wrong.
Posted by: Antaeus Feldspar | October 28, 2009 9:32 PM
Thanks so much for your reply Antaeus. While I recognize that influenza virus can cause pneumonia, as I understand it, there is also an increased (perhaps higher) risk of developing secondary pneumonia, which can be caused by Streptococcus pneumoniae.
I'm not an expert either, just trying to get a better understanding of this and whether or not the pneumovax is a reasonable precaution without access to the H1N1 vaccine.
I believe I'm using good sources for basic info (some of it quite technical though), but putting the risks into perspective is quite a puzzle at the moment.
http://www.virology.ws/2009/06/05/interferons-secondary-pneumonia-after-influenza/
http://www.rxlist.com/pneumovax-drug.htm
http://www.ncbi.nlm.nih.gov/pubmed/19586418
http://www.ncbi.nlm.nih.gov/pubmed/19520922
Posted by: Jane | October 29, 2009 12:31 AM