Friday, 1 May 2020

Coronavirus antics #2

The last post only touched on certain certain issues. Some will be explored in greater depth.  Also, things have moved on slightly...

Update
First, a little background. The first time that UK media reported on homeopaths offering advice/treatment for COVID-19. as the Daily Telegraph Homeopaths promise coronavirus prevention and cures, as health officials criticise 'misinformation' on 02/03/2020. It features Alan Freestone, who the Telegraph caught on video advising a reporter against vaccination (discussed here). Freestone is not a member of the SoH but the SoH are quoted in the article -
A spokesperson for the Society of Homeopaths said: “The Society of Homeopaths has issued the Public Health England guidance on Coronavirus (COVID-19) to its members. The Society requires that registered members adhere to their individual Scope of Practice and should direct enquirers to the NHS and other public health sources, for example, their GP or public health departments.”

Which raises the question of whether treating COVID-19 is considered to be was scope of practice then and if it is now?

At the time of the last post the Society of Homeopaths (SoH) had not made a public statement re prohibition on seeing clients. This was a source of concern. They did eventually make a public statement or rather they amended a previous statement titled "Business as usual" that was previously just about SoH staff working from home. They added -
The COVID-19 pandemic places everyone in isolation and Society Registered members are adapting to the situation by offering online and telephone consultations only. 
Patients are advised to contact their local registered homeopath directly for support and advice around their general health and wellbeing.
Apparently, they had sent out a communication to members prior to this (not clear when) instructing them not to see clients. This has not be seen but the SoH has a history of ambiguous messages.

On 13/04/2020, the Times had an article and a leader that discussed SoH members offering cures/treatment for COVID-19. Not exactly a surprise and something the SoH should have been prepared for as soon as cases first cases turned up in the UK.

The SoH did post a response from their interim CEO on Facebook (and also on their website) -
Dear Sirs 
I write in response to the report, Homeopaths ‘risking lives with bogus coronavirus treatments’ and the Leading Article, The Times view of homeopaths promoting bogus coronavirus treatments: Junk Medicine – The Times Monday 13th April.It is hard to believe that such an august title as The Times would publish articles so lacking in balance, objectivity and factual accuracy.The claim that “hundreds of homeopathic practitioners across the country are promoting treatments against Covid-19 infection” is just not true.
Firstly, homeopathic practitioners treat patients, not conditions. When a patient consults a registered homeopath, their unique set of symptoms is considered before any homeopathic treatments are recommended. What many homeopaths are finding is that, during this most unusual period, they can help patients with a range of physical symptoms, as well as anxiety issues and insomnia. Should a patient believe that he or she has contracted the virus, then homeopaths will be the first to recommend following the advice provided by the NHS.
Your articles go on to state various untruths including that “there is no evidence that homeopathy is effective”. The “report by the House of Commons select committee on science and technology in 2010” to which you refer is out of date and was proved to be incorrect. Professor Robert Hahn, an independent researcher in Sweden, wrote in his 2013 meta-analysis: “To conclude that homeopathy lacks clinical effect, more than 90% of the available clinical trials had to be disregarded.” 
I would also direct you to the Homeopathy Research Institute an organisation founded by the physicist, Dr Alexander Tournier who previously worked as an independent researcher for Cancer Research UK. The HRI conducts and promotes high-quality scientific research into the efficacy of homeopathy and its website has a free database of the latest trails and studies: www.hri-research.orgIn this time when we are facing a worldwide health crisis, we should work together for the greater good. Complementary medicine, including homeopathy, has much to offer. I would ask you to desist from making unfounded and inflammatory statements, which mislead the public, particularly during this period of great vulnerability.

Which misses the point. SoH members were found to be offering "cures" for COVID-19. As 
an example -
The text has been removed but that's not the point. 

It's made this kind of statement before. It raises questions about their commitment to public safety. It would seem that defending its members and homeopathy is far more important than public safety. It's a step backward from how it was positioning itself prior to re-Accreditation. 

Prevention and Cure
The SoH and other homeopathy organisations, as dicussed in the last post, suggesting treatments for COVID-19 as well as "preventative" measures. 

Some homeopaths suggest Arsenicum album as a preventative. This seems to have, if not originated in India, become quickly established there and spread elsewhere. Other homeopaths have suggested homeoprophylaxis but thankfully, no COVID-19 nosode is currently available in the UK and one that was offered in the US seems to have been removed from the market in response to an FDA warning letter. That was offered by Kari J Kindem who was discussed here re CEASE therapy and homeoprophylaxis. Any homeopathic pharmacy that compunded such a nosode might find themselves in hot water with their regulator and it should not need explaining what the media would do with it. There is a Coronavirus nosode offered by Homeoforce but it's for Bovine coronavirus (which a vaccine exists for). Apparently a COVID-19 nosode is being developed in India but that is part of a different story.

The major concern is that people thinking that they are protected will take more risks and increase the likelihood of them contracting the virus and spread it, potentially to more at risk groups. This is somewhat mitigated by lockdown, police powers to enforce and social pressures. Those not obeying the lockdown have been called "covidiots" and there have been numerous media stories about them.

Claims to have "cured" COVID-19 are problematic. First off, there is the problem of a definitive diagnosis. Testing is still restricted to certain groups in the UK. The symptoms of COVID-19 are variable and overlap with other respiratory infections. Seasonal flu and colds don't go on holiday because there's a pandemic. Secondly, many cases resolve in a couple of weeks. Those who develop severe symptoms are not going to seek treatment from a homeopath and the very unlikely event that they do, something is very wrong if the homeopath does not insist that they seek urgent medical treatment.

It's unclear whether reported re-infection by COVID-19 is genuine re-infection or the virus laying dormant for a while only to re-activate. It is possible that both are going on. There are also concerns that tests are giving false positives.

Offering to treat symptoms is a slightly different matter. It goes against the grain of treating the "root cause" of disease and claims of "complete cure" as result but that has never stopped homeopaths and manufacturers from advertising symptomatic treatments.




Indeed, that's all that medicines regulation allows. Anyway, the promotion of particular remedies is contrary to so-called individualised prescribing. Homeopathy doesn't treat the disease, it treats the person or something along those lines.

Of course, any marketing claim runs into the problem of substantiation.

Not satisfied with claims to treat etc COVID-19, some homeopaths make claims about homeopathy be able to help with anxiety and other issues resulting from fears about COVID-19. The use of homeopathy for mental health issues will be discussed in a future post but it is noted that some of actions and words of homeopaths serve to generate and increase anxiety. 

Germ Theory Denialism and Disease causation
Yes, there are homeopaths that believe that pathogens are not the source of disease. There is some variation but some believe that the virus is the product of disease rather than the cause of the disease. Ideas about what causes disease vary but can be almost anything but pathogens.

Disease as a punishment or test from God is not unknown in Christianity. In some cultures, it is believed that illness can be caused evil spirits or sorcery. Homeopaths tend not to come right and say that sort of thing but the idea that disease can have a spiritual cause is strong in some. Thoughts and feelings are also posited as a cause of disease. There are also ideas about karmic causes of disease - that bad actions result in physical illness. This needs to be distinguished from Anthroposophic ideas about disease.

More often, germ theory denialists will seize upon toxins as a cause of disease. Whilst certain toxins can cause certain diseases there is to see almost all diseases that way. There is a tendency to see anything not deemed "natural" as a toxin - it is part of the appeal to nature fallacy. Similar ideas exist about radiation.

Of course, germ theory denialists will offer up explanations for epidemics, often linked to particular conspiracies or anxieties about toxins/raditation. The greater concern are their behaviours. As with homeoprohylaxis, germ theory denialism could lead to a false sense of security and thus to risk taking behaviours.

Misinformation
There is an awful lot of this. Not all of it originates with homeopaths themselves. 

Depicting COVID-19 as little worse than seasonal flu or a cold is not uncommon. Without comprehensive testing it is difficult to know how infectious it is or what the actual mortality rate is (but see here). There are some reports as well that it can cause long term issues due to organ damage. Some homeopaths try to play down how dangerous COVID-19 is by saying that those who have died were ill anyway. They died with COVID-19 rather than from COVID-19. Homeopaths likely do not understand immediate and proximal cause. Comorbidity can be a difficult concept for homeopaths - they "treat the person, not the disease" - and causation can be tricky for them too.

Homeopaths like certain others have a very poor grasp of the immune system. It is complex, no two ways about it. Biological systems generally are. Science's understanding is is far from complete. But homeopaths et al come out with simplistic tropes such as "natural immunity" in the anti-vaccination context and "boosting of the immune system". Apparently, the immune system can be boosted by certain foods and supplements. 

The debunked story that ibuprofen supposedly worsens COVID-19 did gain traction with some homeopaths. It fits in with the "don't treat fever" mantra that some recite. Certainly aspirin should not be used to treat fever in children due to potential for Reye syndrome. Paracetamol is absoutely contradindicated for certain conditions. Yes there are arguments that antipyretics should not be used but fever can be a miserable experience and the desire to reduce suffering is understandable. 

Homeopaths do have a tendency to fixate on "reports" that they think are supportive of homeopathy. Some of those reports have nothing to do with homeopathy - it's more a case of if something is critical of conventional medicine than means homeopathy is good. There is also a tendency to look favourable on the pronouncements of anyone who has said anything even vaguely positive about homeopathy in the past.

Luc Montagnier is often cited by homeopaths because they believe his research into DNA "teleportation" proves homeopathy or something.  When Montagnier claimed that COVID-19 had escaped from a laboratory, this was repeated by homeopaths.

It was widely reported in the Indian media that Prince Charles had been cured of COVID-19 by a combination of homeopathy and ayurveda. Some UK homeopaths picked up on this. It turned out not to be the case and is quite an ugly little story (and will be discussed in a future post). 

Conspiracy Theories
Research suggests that belief in homeopathy and belief in conspiracy theories can go hand in hand. It doesn't come as a surprise that homeopaths are sharing COVID-19 conspiracy theories.

5G conspiracy theories have been around for a while now but seem to have gained a lot more traction. Opposition to 5G is not uncommon among homeopaths and some have spread the theory that 5G causes COVID-19 in one way or another. 

As discussed in this post and the following one, some homeopaths are active in Arnica Group. Arnica Group is anti-vaccination and its Facebook page and various closed groups are often used to spread anti-vaccination misinformation and conspiracy theories. Now it is spreading COVID-19 conspiracy theories. Some members are suggesting useless treatments as well. It may now be moderating comments but it is too little too late. A perusal of its Facebook page reveals all of bad advice and conspiracy theories. Facebook already flags Arnica Group as anti-vaccination (although the wording is milder). Social media companies are under pressure to go further with clamping down on problem content and that pressure is not going to reduce whilst COVID-19 is still going on.

Big Pharma and "medical mafia" conspiracy theories are common among homeopaths. The exact formulations vary both in extremism and detail. Some posit that Big Pharma or the like created COVID-19 for some reason. Other theories merely suggest that Big Pharma and others are exploiting COVID-19 for their own purposes. Homeopaths tend towards the latter though. Similar to this is the idea that "natural cures" for COVID-19 are being suppressed by Big Pharma et al. 

Ugly
It seems unlikely that UK homeopaths spread misinformation and conspiracies theories do so with bad intentions. It is quite obvious that there are groups that are using COVID-19 to advance their own agendas and these groups aren't associated with Big Pharma. Far right groups certainly are using it. Homeopaths can end up serving their purposes when they spread conspiracy theories even if they consider themselves to be against their politics.

There is considerable irony in that homeopaths are all to ready to accuse critics of being Big Pharma shills when they unwittingly act as useful idiots for sinister groups.



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