TRIBUNE – John Ioannidis is one of today’s great figures in epidemiology. Having made himself known in 2005 by an article entitled ” Why Most Search Results Are Fake “, quickly became the most downloaded of the prestigious Public Library of Sciencehe had then opened an important and fruitful debate around the quality of scientific production.
Professor of Medicine, Epidemiology and Population Health, and Medical Data Science at Stanford University, Co-Director of the Meta-Research Innovation Center at Stanford (METRICS), Ioannidis is currently considered the world reference in terms of epidemiology and public health. A humble and discreet man, he rarely appears in the press or on social media. On the other hand, his scientific production is remarkable and is among the most cited by other researchers.
Professor Ioannidis did not remain inactive during the Covid-19 crisis. He indicated as early as March 17, 2020 that we were likely heading for an unprecedented fiasco in medical data collection. The absence of clear categories, the catch-all of the dead declared COVID without taking into account the causes of death, the errors around the use of PCR tests and “asymptomatic cases” made him say very early on that we lacked the right indicators to assess the severity of the epidemic and the relevance of the measures put in place. implemented.
In April 2020, however, he gave with remarkable precision the order of magnitude of the lethality of Sars-CoV-2, establishing that it was not particularly worrying in view of the usual respiratory epidemics. These analyzes will be confirmed a few months later and taken up very officially by the WHO, then revised downwards again recently.
In July 2020, he delivered (with Italian colleagues) an analysis of the famous situation in Northern Italy, which struck people’s minds by giving a very worrying signal as to the dangerousness of the new coronavirus. The authors showed that this was a circumstantial effect due to a convergence of parameters. The fact that no other region of Italy experienced either before or after a comparable situation confirmed their analysis.
Surprised like all connoisseurs by the imposition of coercive measures recognized in the literature as being ineffective and destructive (due to the inevitable collateral damage), he produced in December 2020 with various colleagues a comparative analysis from 63 countries and territories confirming the ineffectiveness of these measures.
A cardinal principle in public health, systematically violated since March 2020, stipulates that coercive and potentially harmful measures can only be imposed on the population on the express condition that they are absolutely necessary and certainly effective.
Here, this principle has been purely and simply abandoned: we have imposed a succession of coercive measures of unprecedented aggressiveness, without having the slightest guarantee that they would really be of any use, and even though we had the example that various States abstained from it without their results being particularly problematic, quite the contrary.
This article was the subject of a violent smear campaign, which Ioannidis took with his usual modesty and a certain philosophy. However, he will testify that he has never been confronted with such aggressiveness from his colleagues in the academic world and the press.
Assessment after more than two years of Covid crisis
A year and a half later, John Ioannidis has just published another article in the journal Frontiers in Public Health with her colleagues Michaéla Schippers (from the University of Rotterdam) and Ari Joffe (from the University of Edmonton). These three experts question themselves exhaustively about the evaluation of the effects of the measures called ” non-pharmaceutical interventions (INP), the damage they caused and the conditions under which they were imposed.
This category includes all non-medical measures, including confinements, closures of schools, shops, restaurants, administrations and businesses, movement restrictions (border closures, curfews), the use massive number of PCR tests, tracking devices, the imposition of mask wearing, etc.
While they cautiously note that some experts believe that these measures have been useful and proportionate, the authors point out that:
has. They were not provided for in any pandemic plan because they had been repeatedly assessed as being inconclusive and harmful (including in 2019 by the WHO).
b. The most solid meta-analyses confirm this lack of usefulness as well as the seriousness of the damage they cause.
vs. The few studies claiming the opposite are characterized by an extremely low degree of scientific validity.
The authors therefore strongly recommend that measures that are still in force be terminated and that their re-adoption in the future be avoided in favor of measures “ non-disruptive “. Based on more than 400 scientific references, they question the collective process that led to the widespread adoption (at least in developed countries) of dubious measures, noting in passing a certain number of relevant reasons.
They thus observe that in times of great insecurity, populations tend to expect authoritarian responses from governments, which may therefore be tempted to respond by deviating from good practices, and by de facto maintaining both a state of unreasonable fear and a dogmatic injunction to adhere to authoritarian measures.
We have thus witnessed a mass movement leading to the sterilization of scientific and democratic debate, with an exacerbated aggressiveness on the part of the majority against the minorities contesting the relevance of the measures, in processes of social psychology typical of totalitarian moments. The authors stress that there is no need to presuppose a deliberate intention to this phenomenon, the combination of an exaggerated perception of danger and an almost blind trust in solutions falsely presented as necessary and effective sufficient to make account for this shift.
This then leads to centralized decision-making processes, driven by a single narrative and therefore inevitably defeating collective intelligence. We have, for example, put forward a “ scientific consensus which in reality did not exist, by censoring or denigrating experts (even highly competent ones) who ventured to contradict the dominant narrative.
This distortion in the perception of risk with the imposition (by governments, “authorized” experts and the media) of a real “health” ideology has prevented a lucid and balanced look at the effects of the policies implemented. . These have particularly hit the most vulnerable population groups hard by aggravating a whole set of economic, social, educational, gender and other inequalities.
The authors insist on the fact that they do not frame their analysis in a logic of blame and that their aim is not to maintain the polarization and the unhealthy divisions that have developed within society.
On the other hand, they insist on the fact that it is essential to carry out an honest and exhaustive evaluation of the measures that have been taken and of the processes that founded them.
Is an honest assessment possible?
At the question “ could we have done better? », the authors give a clearly affirmative answer. In particular, the process described under the term ” emergency management (GU) has largely been defeated by the authoritarian drift of public responses, which have not adequately taken into account observable data, nor respected good public health practices.
According to them, it is necessary to get out of this dynamic of domination and single thought to take the path of collective healing. This would involve restoring community processes instead of top-down injunctions, by reopening the space for respectful, intelligent dialogue, and therefore naturally open to a diversity of analyzes and opinions. The lack of consideration of the overall health needs of the population (and not of a single parameter such as the circulation of a virus that is otherwise harmless for the population under 70) constituted health nonsense. serious and particularly destructive
The so-called health policies imposed since 2020 have created a huge shock causing a traumatic state accompanied by a loss of meaning within the population. The orientation of the resulting aggression towards groups designated as enemies (labeled as antivax, conspirators or corona-skeptics) is a usual process of unloading stress against stigmatized social groups in times of high uncertainty.
It is time, propose Ioannidis, Schippers and Joffe, to get out of this way of doing things, which will have led political leaders and health agencies to turn away from knowledge and good principles in public health to embark on health policies. destructive, from a stronger for the most vulnerable groups of the population.
Their article names in a clear and documented manner the problems and excesses that a certain number of experts have tried to raise for three years while suffering attacks and insane denigration campaigns in return.
What matters at this stage is whether or not our governing bodies will finally be able to take a step back to honestly assess the effects of the measures imposed.
The authors underline in their article to what extent the reflexivity necessary for the quality of the decision-making processes has been lacking. Experts from health agencies as well as politicians have lost along the way the necessary openness to question their decisions in the light of observable data.
It is therefore a major challenge to find the path of this reflexivity, where unfortunately the current political game seems to be, while conveniently recognizing that ” nothing is ever perfect », to resist at all costs that the reality of failures, errors, or even faults if there were any, can be brought to light.
The calm, measured and nuanced tone of this article makes it a production of choice to share with all those who have retained sufficient open-mindedness and critical thinking.
These qualities being unfortunately the first to be undermined in mass phenomena such as the one we have experienced, it is all the more urgent that we restore the conditions for a respectful and constructive dialogue favoring this collective intelligence which has so missed since March 2020.
Jean-Dominique Michel is a medical anthropologist, health expert and member of the Independent Scientific Council.