Since Prof. Risch referenced his own opinion article in AJE, I figured that I had to go and take a look at it. At this point, Newsweek annoyed the crap out of me because there was no direct link to the article, forcing me to go to the extra step of Googling its title and finding the article. Come on, Newsweek! It’s 2020! There’s no excuse for not including a direct link to the source and hasn’t been for at least a decade! Here, by the way, is the direct link. At this point, I would also like to point out that Prof. Risch is on the editorial board of AJE, a fact conveniently not mentioned in his Newsweek op-ed that is highly relevant, given that editorial board members can exercise a lot of influence on what gets published in a journal.
Reading the article, I was struck at how weak the arguments were. Prof. Risch basically tries to compare hydroxychloroquine to remdesivir, which I discussed nearly three months ago, when the results of the first randomized clinical trial (RCT) was announced, in essence, by press release. And, guess what? I’m not that impressed with the evidence for remdesivir’s efficacy against COVID-19, either!
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The rest of Prof. Risch’s AJE article is a veritable Gish gallop of cherry-picked studies. Hilariously, he relies heavily on uncontrolled “studies” and case series from two grifters, Didier Raoult and Vladimir Zelenko. I’ve written about Didier Raoult, a “brave maverick” true believer in his combination of hydroxychloroquine and azithromycin and a bully, on several occasions, starting with his truly execrable study claiming that his combination of hydroxychloroquine and azithromycin cleared coronavirus in all patients. None of these studies were controlled or randomized. Unbelievably, Prof. Risch cites Raoult’s case series of 1,061 COVID-19 patients as though it were anything but singularly uninformative and useless for evaluating whether his drug combination is effective against COVID-19.
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I had a hard time believing that an actual professor of epidemiology at a school as reputable as Yale could write such drivel. The study he is referring to is Gautret et al., a study so awful, so full of flaws (and maybe even fraudulent), that it was quite properly dragged on science and medical Twitter for days and weeks afterward. That Prof. Risch would cite such an abomination of science tells you all you need to know about him.
Next, Prof. Risch cites Vladimir Zelenko. No, seriously, an epidemiologist is citing an unethical case series that hadn’t even been published yet in May. The link he provides in the citation is a link to a Google Documents page that no longer exists and was last accessed in April. I suspect that this was probably the same spreadsheet of patients that Zelenko had posted in early April that looked like this. I’m now leaning towards Prof. Risch’s commentary having not been peer-reviewed, because if an AJE peer reviewer let an author cite a link to a Google Document and call it a “two-page report,” its peer review sucks, and its editor should be ashamed of himself for publishing this. Zelenko’s evidence is so crappy that anyone citing it seriously should be thoroughly mocked.
The fourth study cited by Prof. Risch is the Prevent Senior study carried out in Brazil. It, too, was an awful study, as outlined by Elisabeth Bik. There was no randomization and no good documentation if the patients actually had COVID-19 or not. The two groups compared were not equally sick, and the reasons for hospitalizations and deaths were not listed. Moreover, the study was performed by an insurance company in Brazil which was promoting its telemedicine app for COVID-19:
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Seriously, this is embarrassing. Prof. Risch’s article should really be retracted. It’s that bad. The comments published about it were deservedly scathing, and Prof. Risch’s responses to the criticisms were downright embarrassing, basically doubling down and dismissing valid criticisms, while pulling the “delay can’t be tolerated during a pandemic” gambit.
