 Soon, the government will exert unprecedented control over what California doctors can say to their patients about COVID-19. We got to stop the disinformation pipeline. Essentially, it puts the CDC in the same room with the doctor and the patient. Governor Gavin Newsom signed AB 2098 into law this September. And starting in the new year, doctors who disseminate what the state defines as misinformation or disinformation related to the SARS-CoV-2 coronavirus can face disciplinary action by the California Medical Board, including being stripped of their licenses. These are doctors who are licensed physicians who carry the same license as I do, who provide legitimacy to disinformation. It essentially ends your ability to combat bad ideas put out by public health because you have this looming power over you that essentially can end your career. Stanford economist and medical school professor Jay Badacharia was one of several scientists whose work NIH director Francis Collins said needed a quick and devastating published takedown in an email to Anthony Fauci that was obtained through a FOIA request. Badacharia was one of these scientists behind the Great Barrington Declaration. In October 2020, open letter calling for an immediate end to the lockdowns and use of an alternative COVID-19 mitigation strategy called Focus Protection. Collins called Badacharia, who was a professor of medicine, economics and health policy at Stanford, a fringe epidemiologist along with his co-signers, Harvard's Martin Kuldorf and Oxford University's Dr. Sunetra Gupta. This kind of campaign essentially put the government in the role of suppressing legitimate public policy debate, public health debate about what the right strategy ought to be. They put their finger on the scale. The idea was to create this illusion of consensus around the lockdowns that didn't actually exist. I mean, I think quite dangerous and led to tremendous bad outcomes for people all around the world. I think it's very dangerous for public health to think that it has a monopoly on the truth. Badacharia says that same illusion of consensus is what California lawmakers are leveraging to quash dissent among doctors across the entire state. The law defines COVID-19 misinformation as medical advice contradicted by contemporary scientific consensus, though does not specify how to define such a consensus. Regardless of your views on the state of California's coronavirus response policies or their public health policies, I think any person left, right, liberal conservative who goes to their physician and asks them a question about COVID treatment or COVID interventions wants to actually know what their physician thinks. They don't, no one wants a doctor who's just reading from a script that was written by the California Department of Public Health. Aaron Cariotti is a psychiatrist and former professor who taught bioethics at the University of California Irvine's medical school. He was fired after he refused to comply with the university's vaccine mandate and published an essay critical of the policy. He's also a co-plaintiff in a lawsuit filed by the New Civil Liberties Alliance, a non-profit law firm that views the administrative state as an especially serious threat to constitutional freedoms. The suit, which has yet to be heard, is challenging the California law on the grounds that it violates free speech and due process rights. Science and censorship are in fact incompatible. The reason is that the scientific enterprise proceeds and makes progress and moves forward by conjecture and refutation, by generating a hypothesis and doing a study to potentially refute the hypothesis. It has to be an ongoing, open conversation where debate, where novel perspectives, where challenges to orthodoxy or conventional thinking are not only permitted but welcomed and then tested against the empirical evidence. That's how science proceeds. So trying to fixate whatever the current consensus happens to be and lock it in in law is something that cannot be challenged by physicians. Bill stifled the progress of science and that's obviously going to be a bad thing, not just for the practice of medicine but for the advance of medical science and the advance of treatment recommendations which need to be revised on an ongoing basis, especially for a novel illness like this that we're still learning so much about. The bill's authors didn't reply to our interview requests, but Democratic Assemblyman Evan Lowe had this to say upon introducing the bill. The definition of misinformation is malicious intent. It is very specific, very direct, and it's important that we help allow the California Medical Board to have these definitions in place to ensure the integrity of our healthcare system and provide an opportunity to save lives. What would you say is the proper role of a medical board? How does it effectively identify cranks or quacks who are legitimately harming their patients? So that's a great question. It's not an easy question, legally I will admit that. But historically, and as medical boards have functioned really up until the pandemic as far as I have seen, is that they tend to give physicians very wide discretionary latitude to make specific medical judgments. The law in California specifies that the medical board cannot discipline physicians, for example, for engaging in complementary or alternative medical practices so long as they have some level of evidence to support them. So you can do things in medicine that are outside of the allopathic mainstream, and the medical board cannot discipline you. And that's good for patients who want to seek out medical providers that are doing things that may be a little bit outside of the mainstream. Now those doctors have a duty to give the patient the information on. This is what we know. This is what we don't know. This is the evidence or the lack of evidence. If doctors are practicing medicine that harms patients, malpractice laws protect patients against that. Those laws are completely legitimate in my eyes. This law, what it does is prevents doctors from dissenting against reigning ideas in public health, even when public health is wrong. Governor Gavin Newsom added a signing statement that this bill does not apply to any speech outside of discussions related to COVID-19 treatment within a direct physician-patient relationship. But Botticharia says supporters of the law hoped to use it to silence doctors on social media. The lawsuit alleges that one of the groups that lobbied for the law, no license for disinformation whose representatives didn't reply to our interview request, regularly threatened him and other dissenting physicians in the lead-up to the law's passage. With a member of the group tweeting at one plaintiff, I look forward to reporting you to your medical board once a certain law is passed in California. When we reached out, he told us that I hope the suit gets tossed and they all deserve to lose their licenses. Why did they attack me? Well, it's not because I'm posing any risk to patients. I don't care for patients. I do research full-time. They attacked me because the idea of the law, the real purpose of the law, is to limit dissent against public health generally by authoritative figures, especially doctors. During testimony in favor of the bill, the founder of No License for Disinformation pointed not to a physician practicing medicine, but to a group of doctors who held a press conference. A group of physicians calling themselves America's front-line doctors, led by a licensed California physician named Simone Gold, held a press conference in what can only be called the most prolific public showing of disinformation to date. If you've gotten the virus, there's treatment. That's what we're here to tell you. Regardless of how one feels about the message put forth by this particular group of doctors, Baracharia says that mentioning them during the debate of the bill is evidence that the target is not only physicians in practice, but any public dissent from doctors. Although the letter of the law may say, just let's limit what happens in patient rooms, even that's bad enough as we've already discussed, in fact, the effect of the law will be to suppress free discussion by doctors who are afraid of losing their license if they disagree with public health online and elsewhere. The rationale written into the text of the law is that COVID-19 has claimed millions of lives worldwide, including tens of thousands in California, and that the safety and efficacy of COVID-19 vaccines has been confirmed through evaluation by the Federal Food and Drug Administration. It's plausible to say that it was true at one time, but as the virus has evolved and as time has gone on and we have more distance from the time of vaccination to the infection, that that claim may not be as true anymore. That reasoning also ignores the fact that a doctor's recommendation has to be tailored to the needs of this specific patient in front of me, so the all-or-nothing claim that vaccines are safe and effective glides over the very significant, for example, age stratified differences in the risks and benefits of the vaccine glides over the significant risk and benefit difference between someone who's never had COVID and someone who's already had COVID and has natural immunity. So it's not necessarily the case that a doctor who's recommending the vaccine for an 80-year-old with diabetes would also want to recommend the same vaccine for a 6-year-old or a 16-year-old or even a 26-year-old. A law like this doesn't take account of that aspect of medical care that needs to be individualized to the patient. Caryati says that this law is the latest example of a trend towards an increasingly centralized bureaucratic health system that prioritizes control and surveillance over individual patient needs. The topic he covers at length in his book, The New Abnormal. The subtitle is The Rise of the Biomedical Security State, which is kind of the melding of public health, digital technologies of surveillance and police powers of the state, the laws or the regulations that are governing the practice of medicine and governing people's lives at ever more subtle levels. Even though a lot of these policies have been rolled back, I don't think we've seen the last of this kind of movement in this direction. Again, I think a big part of that is going to be increasingly sort of squeezing and compromising physicians, what I call before physicians, discretionary latitude, their ability to make patient-specific judgments, their ability to think and to practice medicine according to their best judgment, according to their own interpretation of research and the medical literature, according to their own clinical experience. I worry that doctors are increasingly going to become functionaries in a larger sort of public health apparatus that doesn't know how to individualize care to the needs of specific patients, but takes this kind of all-or-nothing approach to managing a problem like COVID. What are some of the best ways to either reverse or at least halt that to escape the new abnormal? We need to end the declared state of emergency at the federal level and at the state levels. So here in California, we're still operating under a state of emergency, which gives Governor Newsom and his appointed public health officials, unelected officials, extra constitutional powers that they wouldn't otherwise have outside of the emergency. President Biden announced a month or so ago in 60 minutes that the pandemic was over, which was true. In fact, it's been over for quite some time, but many of his advisors immediately panicked and said, no, no, no, you can't say that. The reason they panicked is if it's true that the pandemic is over, then the state of emergency, the federal state of emergency, which is renewed by HHS Secretary Javier Becerra with the endorsement of the president and has been renewed every three months for the last three years, almost, that will have to end. And when that happens, the 128 additional extra constitutional powers that the president gains during this declared state of emergency will have to be relinquished. And the powers that HHS and its its agencies like the CDC, FDA, NIH gain will also have to be relinquished. The emergency use authorizations of the vaccines no longer apply if we're not under a state of emergency. The Pfizer and Moderna vaccines are fully FDA approved for adult use, but an emergency use authorization still covers use among minors. Cariotti also favors decentralizing research funding so that less of it is directed by federal officials like Anthony Fauci and Francis Collins at the National Institutes of Health, who can make or break the career of a scientist by funding or denying them grant money. The lawsuit against California was filed in November and has yet to be heard by a judge. If no ruling is issued in the coming weeks, AB 2098 will become California law starting January 1st. The fundamental problem is the loss of authority in public health because they have squandered their authority to correct the record. Rather than being honest about what was known or not known, calling for more studies when they were needed to resolve these uncertainties, public health should not rule over the public. Public health should be partners with the public in promoting health. I think humility would be the watchword in my reform public health.