Vinay Prasad's Observations and Thoughts

Vinay Prasad's Observations and Thoughts is a Substack that critically examines issues within medicine, healthcare policy, and related societal impacts, with a focus on evidence-based medicine, the politics of healthcare, public health recommendations, and academic freedom. It challenges mainstream narratives and calls for transparency, ethics, and rigorous scientific scrutiny in health policy and practice.

Health Policy Public Health Recommendations Evidence-Based Medicine Academic Freedom Political Influence in Medicine COVID-19 Policies and Measures Vaccine Safety and Efficacy Research Integrity and Academic Misconduct

The hottest Substack posts of Vinay Prasad's Observations and Thoughts

And their main takeaways

UCSF has match day outdoors & plans on contact tracing... in 2024

132 implied HN points • 16 Mar 24
🏥 Health Politics Medical education Public Health Risk management
  1. Population immunity to COVID-19 is high, making large outdoor gatherings unnecessary. Holding events outdoors may not significantly impact transmission and could be inconvenient.
  2. There is little evidence to support the need for contact tracing in 2024. The effectiveness of contact tracing for the virus is questionable.
  3. Medical school policies may sometimes prioritize perceived safety over rational decision-making, potentially impacting student experiences and learning.

The New York Times still won't cover covid honestly

200 implied HN points • 04 Mar 24
🏥 Health Politics COVID-19 Healthcare Media Opinions
  1. Improving air quality did not stop COVID19 in Kindergartens. No evidence shows that upgrading air quality reduces seasonal respiratory viruses effectively.
  2. Masking may not be necessary in 2024. Few individuals are wearing masks as they are inexpensive and easily available online, suggesting a reduced need for them.
  3. The New York Times seems to be biased in covering COVID. It is important to accept life's risks, not wear masks unnecessarily, and focus on socialization and personal care.

What is happening to medical students?

220 implied HN points • 22 Feb 24
🏥 Health Politics Political Activism Medical education Leadership
  1. Students shouting down speakers at the University of Chicago raised concerns about their behavior and the medical school's leadership.
  2. Debating whether the AMA should issue a statement on the war highlighted the complexities of making impactful statements and maintaining professional standards.
  3. The lack of courage in inviting diverse speakers and fostering debate in medical schools may contribute to a culture of protest among students.

A flawed paper claims COVID19 vaccines prevent cardiovascular complications for a YEAR after the shot

67 implied HN points • 18 Mar 24
🏥 Health Politics
  1. When reading medical papers, it's important to consider the methodology used by researchers and look beyond just the main data presented.
  2. It's crucial to be aware of negative control outcomes, which are endpoints that cannot possibly be linked to the exposure being studied.
  3. The flawed paper in question claims that COVID-19 vaccines prevent cardiovascular complications for up to a year after vaccination, but upon closer examination, the study's methodology and conclusions are highly questionable.
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Apoorva Mandavilli keeps making mistakes at the New York Times to exaggerate the risk of COVID to keep Americans scared

162 implied HN points • 18 Feb 24
🏥 Health & Wellness COVID-19 Journalism Medical Misinformation
  1. Apoorva Mandavilli is accused of making mistakes and exaggerating COVID risks to keep Americans scared
  2. Critics claim that Mandavilli's reporting lacks journalistic integrity and is more aligned with activism
  3. There are concerns about bias in Mandavilli's reporting, including inaccurate statistics and flawed analysis

If results are too good to be true, you can't exclude harms

71 implied HN points • 07 Mar 24
🏥 Health & Wellness Research Vaccination Pregnancy Study Side Effects
  1. Results that seem too good to be true may not be accurate and can hide potential harms or biases.
  2. Confounded studies, where data is influenced by other factors, can be misleading and unhelpful in drawing conclusions.
  3. It's important to consider the full data and potential biases in research studies, especially when interpreting studies involving vaccinations during pregnancy.

Robert Califf the FDA commissioner is making inappropriate and irresponsible claims about vaccines and boosters on twitter

176 implied HN points • 04 Jan 24
🏥 Health Politics FDA Vaccines Boosters Misinformation Twitter
  1. FDA commissioner Robert Califf is making inappropriate claims about vaccines and boosters on Twitter.
  2. Califf's claims are not supported by randomized trials, which go against FDA standards.
  3. Califf is spreading misinformation and using low quality evidence, acting more like a Pfizer spokesperson than a respected academic and scholar.

Science may not be able to exist on controversial issues

60 implied HN points • 19 Feb 24
🔬 Science Controversy Ideology Research
  1. Some controversial issues may not allow science to exist due to preconceived notions and ideology dominating the discourse.
  2. Activists can potentially cause harm if their actions and beliefs overshadow scientific reasoning and discussion.
  3. The dominance of preconceived notions and ideology can be observed in various narratives, such as recent reports from organizations like the NHS.

Exercise helps long covid patients in a randomized trial

59 implied HN points • 16 Feb 24
🏥 Health & Wellness Exercise Long Covid Research Quality of Life Interventions
  1. Exercise has been shown to improve quality of life for long COVID patients in a randomized trial.
  2. Even with varying levels of participation, the exercise program led to positive impacts on mental and physical health in long COVID patients.
  3. This study highlights the importance of consistent exercise as a potential treatment for long COVID symptoms.

Tomorrow and Tomorrow and Tomorrow

26 implied HN points • 17 Feb 24
📚 Literature Book review Novel Writing Art Characters
  1. The novel 'Tomorrow and Tomorrow and Tomorrow' explores the challenges and nuances of creating art and friendships, particularly in the context of the video game industry.
  2. The book is praised for elevating gaming to the level of art, alongside other creative forms like poetry and music, emphasizing the joy and bonds that come from creating something for others to enjoy.
  3. While the story is engaging and fast-paced, some elements of the plot and character development may fall short of the book's ambitious themes, ending with a less impactful conclusion.

Birnam Wood by Eleanor Catton

25 implied HN points • 10 Feb 24
📚 Literature Book review Themes Technology Psychology Human behavior
  1. Birnam Wood by Eleanor Catton addresses important modern themes like privacy, capitalism, conservation, politics, and compromise, making it a significant literary achievement.
  2. The novel skillfully uses technology to delve into human behavior and psychology, showcasing the eternal themes of infatuation, idealism, and ruthlessness.
  3. The book exemplifies an intriguing juxtaposition of characters and themes, illustrating the challenges of modernity and the consequences of trying to mix incompatible ideologies.

Take RFK Jr seriously: what RFK Jr. gets right and wrong

288 implied HN points • 18 Jun 23
🏥 Health Politics Health Policy Vaccine Safety Public Health Medical Ethics Media Coverage
  1. RFK Jr. has valid points about corporate influence in politics and government corruption.
  2. RFK Jr. highlights failures in Covid-19 policies such as lockdowns and vaccine mandates.
  3. RFK Jr. advocates for stricter oversight on vaccine safety and criticizes the close relationship between FDA and pharmaceutical companies.

Did Republicans die more during the pandemic bc they didn't get the vax?

209 implied HN points • 29 Jul 23
🇺🇸 U.S. Politics Pandemic response Political Bias Vaccine distribution Public Health
  1. A recent paper suggests that Republicans were more likely to die during the pandemic due to not getting vaccinated.
  2. The paper had flaws in its methodology and did not consider factors like age, BMI, and vaccination status.
  3. Criticism of Republicans for not getting vaccinated highlights a double standard in how different groups are treated in research and society.

The only real solution to vaccine skepticism: We need more randomized trials and a new phase IV safety system

206 implied HN points • 29 Jun 23
🏥 Health Politics Vaccines Public Health
  1. Experts need to rely on randomized trials for authorizing medical products to ensure effectiveness and safety.
  2. Implement a new safety system to detect rare vaccine adverse events, using observational and real-world randomization.
  3. Re-examine older vaccines for safety to address growing public distrust, regardless of expert opinions.

Mayo Clinic Suspends A Doctor Who Commented in NYTimes About Testosterone's impact when Trans-athletes compete in Women's sports

230 implied HN points • 08 Jun 23
🏥 Health Politics Academic Freedom Censorship COVID Public Health
  1. Mayo Clinic suspended a doctor for comments on transgender athletes in women's sports, violating academic freedom.
  2. Academics should have the freedom to express their views in media without censorship.
  3. Universities should prioritize the free exchange of ideas over financial gain.

Forest fires and n95 masking

225 implied HN points • 10 Jun 23
🏥 Health Politics Public Health Policy Epidemiology
  1. Public health recommendations should be evidence-based and consider the best use of resources.
  2. When it comes to community N95 masking for forest fires, there is a lack of studies showing its effectiveness.
  3. Randomized trials measuring endpoints in response to N95 masking during forest fires could provide valuable data.