Dr Norman Swan: ME/CFS is more psychosomatic than long-COVID

Simone

Simone

Senior Member (Voting Rights)
In yesterday’s Coronacast podcast (ABC, Australia), Dr Norman Swan (who infamously interviewed Sharpe and Horton in 2011 about the PACE trial, and has remained stubbornly pro-GET), responded to a listener question about long-COVID.

It starts at 8.10, and runs for about a minute: https://www.abc.net.au/radio/progra...erd-immunity-would-save-us-maybe-not/13100018

Norman Swan has provided really solid information during the pandemic, so his credibility is sky high right now, which is a huge problem for us.

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In case the podcast is geoblocked, and to just save you from having to listen to it, here’s a transcript:

Listener question: What evidence is there for long-COVID? Could it just be hypochondria?

Norman: No, it’s not just hypochondria. The pattern is what we call syndromic. There’s a clear syndrome of long-COVID. Fatigue and other symptoms. But it’s not just fatigue, there’s other symptoms as well which creates a clear pattern for long-COVID, as opposed to say chronic fatigue syndrome or a chronic pain syndrome or some other thing like that.

They’re not hypochondria either but they are more (I’ll get killed for saying this) psychosomatic. What I mean there is, essentially, you’ve got a symptom, where something has created that symptom in your brain, and the brain has clicked through neurologically to give a sense of fatigue. Well, not a sense of, a very real feeling of fatigue, a very real feeling of pain. But long-COVID is a much more highly defined syndrome and increasingly it’s been associated with abnormalities in the immune system.
 
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Oh really?!? :grumpy:

He seems to try to describe central sensitization. He is dancing between what he really thinks (psychosomatic) and the fact that he can’t quite say that publicly. He is also quite aware that lots of funding will be made available to examine the immune abnormalities of his long-Covid cohort.
 
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Norman Swan is one of the most problematic individuals in this whole shit show. He made his name exposing a major medical scandal, has a great track record on almost everything he reports on, including COVID-19, and has been one of those who helped set a very high standard for medical journalism.

Except on ME/CFS. It is his blind spot. He bought into the whole BPS con from the start, with not a critical word or question from him, just untiring support. It is like he just threw his brain and ethics out the window when the pyschs came knocking.

Notice how he frames anticipated criticism: They’re not hypochondria either but they are more (I’ll get killed for saying this) psychosomatic.

@dave30th Swan's behaviour on this might be a chapter worth writing up. Also Australian psychiatrist Prof Ian Hickie, whose role in the BPS catastrophe has gone largely unreported.
 
I’ve written a short Twitter thread addressing the inaccuracies in Swan’s comments. Please like, reply and retweet!



I’ve also lodged a complaint with the ABC over the factual errors in his comments. I doubt they will take any action, but at least it’s been lodged. I know others are writing too.
 
https://www.abc.net.au/news/about/b...ghter-anna-trauma-coronacast-covid19/12846668

The story that won him the Gold Walkley was an investigation into research conducted by Australian obstetrician William McBride, who was credited with blowing the whistle on the dangers of the drug thalidomide in the 1960s.

It led to McBride being found guilty of scientific fraud, struck off and reforms in the governance of Australian scientific research.

McBride was regarded as a national hero and Swan endured some ugly blowback.
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You would think that somebody who has been in the position of going against the establishment would understand what that looks like, and maybe even have a little sympathy for the underdog and give them a fair hearing.
 
I'm glad you're on the job @Simone. It's dreadfully frustrating. As you and Sean say, Norman Swan comes across as a very credible source of information and he has influence. I wonder why he has the blind spot, if he is friends with Lloyd or Hickie, or had a bad encounter with an ME/CFS patient in his medical training?

Has Heidi ever chatted with Norman Swan? I wonder if someone like @Brian Hughes could offer to talk about his book on Norman's radio show, and then slip in something about ME/CFS or the Pace Trial? You know, express surprise that anyone would still be thinking that CBT and GET are helpful treatments.

Clearly, treatments based on a psychosomatic foundation tried so far don't work, and there's no evidence that ME/CFS is psychosomatic. But a big problem is that it's still so hard to definitively prove that ME/CFS is not psychosomatic. I mean, as far as positive evidence goes, the immune stuff isn't super solid yet; the natural killer cell ideas that you mentioned Simone aren't robust, even the CPET papers look a bit shaky.

Maybe the best evidence we have are the prospective studies, one by Jason, and the Dubbo study, which found that psychological factors did not predict the development of the PVFS. There is that terrible 2019 re-analysis of the Dubbo study data that tried extremely hard to find a psychological factor that was predictive. It failed, but that didn't stop them writing the abstract up as if neuroticism was a factor. Maybe we need to get on with the rebuttal of that paper and then put it in front of Norman Swan.
 
Hutan said:
I'm glad you're on the job @Simone. It's dreadfully frustrating. As you and Sean say, Norman Swan comes across as a very credible source of information and he has influence. I wonder why he has the blind spot, if he is friends with Lloyd or Hickie, or had a bad encounter with an ME/CFS patient in his medical training?

Has Heidi ever chatted with Norman Swan? I wonder if someone like @Brian Hughes could offer to talk about his book on Norman's radio show, and then slip in something about ME/CFS or the Pace Trial? You know, express surprise that anyone would still be thinking that CBT and GET are helpful treatments.
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I seem to recall that @dave30th offered to appear on Swan's show when he was in Australia but was rebuffed.

Swan's views on people with ME seem to stem from prejudice and bigotry. This behaviour has been consistent for over ten years. Reasoned argument won't change his mind.
 
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Hutan said:
I'm glad you're on the job @Simone. It's dreadfully frustrating. As you and Sean say, Norman Swan comes across as a very credible source of information and he has influence. I wonder why he has the blind spot, if he is friends with Lloyd or Hickie, or had a bad encounter with an ME/CFS patient in his medical training?
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Yes, it’s very frustrating but not all that surprising. Swan has been pro-PACE/GET for years. He is mates with Hickie, which I’m sure plays a huge role in this blind spot. It’s a shame he’s been so unwilling to bring the same scientific rigour to ME/CFS that he’s brought to COVID-19.

Hutan said:
Has Heidi ever chatted with Norman Swan? I wonder if someone like @Brian Hughes could offer to talk about his book on Norman's radio show, and then slip in something about ME/CFS or the Pace Trial? You know, express surprise that anyone would still be thinking that CBT and GET are helpful treatments.
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No, Heidi hasn’t. Swan has refused all approaches from the community. We’re not even trying anymore. It’s not worth it. It’s like asking whether a sit down meeting with Peter White would result in him changing his tune. He’s rigid in his views, and is unlikely to be convinced to shift, even by someone like Heidi. I doubt he’d agree to have anyone like Hughes on any of his programs. I don’t think he’d be willing to be challenged so directly. I think our best bet is to focus on shifting views around him, and he will eventually have to get on board.

My focus with the Twitter thread wasn’t to convince him, it was to target listeners of the podcast.

Hutan said:
Clearly, treatments based on a psychosomatic foundation tried so far don't work, and there's no evidence that ME/CFS is psychosomatic. But a big problem is that it's still so hard to definitively prove that ME/CFS is not psychosomatic. I mean, as far as positive evidence goes, the immune stuff isn't super solid yet; the natural killer cell ideas that you mentioned Simone aren't robust, even the CPET papers look a bit shaky.
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The NK cell data may not be super robust, but I doubt they’re any less robust than his claim that long-COVID is starting to be associated with immune abnormalities. It is super frustrating to try to support our arguments when the literature is so inconsistent, but using his loose standard, I felt okay about using NK cell functioning.

Every time this stuff happens, it just brings me back to research and just wishing we had more definitive, consistent, robust results. Nonetheless, Swan was intimating that there’s an absence of any abnormalities, which isn’t the case.

Hutan said:
Maybe the best evidence we have are the prospective studies, one by Jason, and the Dubbo study, which found that psychological factors did not predict the development of the PVFS. There is that terrible 2019 re-analysis of the Dubbo study data that tried extremely hard to find a psychological factor that was predictive. It failed, but that didn't stop them writing the abstract up as if neuroticism was a factor. Maybe we need to get on with the rebuttal of that paper and then put it in front of Norman Swan.
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We could definitely look at a rebuttal of that 2019 paper, but I doubt that putting it in front of Swan would achieve much. Even Jason’s studies wouldn’t count for much. If he’s anything like Lloyd, he would just see it as a researcher finding what he wants to find.

Sadly, I think that, until we have a diagnostic test and clear, robust and consistently replicated abnormalities, he will stick with his views that the condition is psychosomatic.

Fortunately, most of the time he ignores us, which is much better!
 
But hang on, Dr Paul Garner has assured us that Long Covid is in fact completely psychosomatic and can be reversed by mobilising those autonomic reflexes in the brain. He has proved it by snapping out of it.

I think these people are going to end up in a sorry mess.
Sadly, misinformation will persist in one form or another.
 
Sean said:
You would think that somebody who has been in the position of going against the establishment would understand what that looks like, and maybe even have a little sympathy for the underdog and give them a fair hearing.
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That was a long time ago. He's been comfortably enscosed at the ABC for a long time since then. The way that Swan got McBride was to quietly accumulate data on him over a period of many years when no-one else in the medical profession would touch it, though many were aware of what was going on with McBride's fraud.

I suggest continuing to do much the same thing: Patiently accumulate data on ME/CFS and, when we have it, wallop all the frauds with the facts.

Fun Fact for the Aussies here: Dr Swan was responsible for Phillip Adams (a notable, lefty broadcaster, for those OS; host of Late Night Live, which is just this week celebrating its thirtieth year) moving to the ABC. Swan already worked there and invited a sceptical Comrade Adams in.
 
What's interesting to watch is the shocked reactions from journalists who interview long-covid patients when they tell them that their doctors told them their symptoms are psychosomatic. They are left speechless.

And yet here we are.
 
Mij said:
What's interesting to watch is the shocked reactions from journalists who interview long-covid patients when they tell them that their doctors told them their symptoms are psychosomatic. They are left speechless.

And yet here we are.
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And all they're describing is standard practice for chronic illness. Which isn't hard to understand because we describe the same thing. So it's not as if any of this should be surprising, given that it's very common and has been openly controversial for decades.

The denigration is one thing, but to bizarrely insist that ME is fatigue and nothing but fatigue is straight up lying. Personally disagreeing with facts is not a thing that should be allowed, and yet here we are indeed.

One thing you find with all those people pushing the BPS line is that they are embarrassed to explain what they actually believe because there is simply no evidence for it and they know it. They are genuinely embarrassed to admit this is just something they believe, which is normal. And yet they still do it, they still opine about whatever happens to make sense in their minds, unrelated to actual reality. It's maddening, they know it's wrong and still they do it even though it has real life consequences.
 
Sean said:
has a great track record on almost everything he reports on, including COVID-19, and has been one of those who helped set a very high standard for medical journalism.
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I disagree. Much of his COVID-19 reporting for example has been of typical journalistic quality - eg talking about the week's hot topic and lacking a true scientific perspective.

There is plenty to criticise.
He was saying severe COVID-19 cases were due to a cytokine storm, despite the continued lack of evidence for this. He's repeated the questionable claims about the AstraZeneca 90% low-dose-standard dose efficacy many times without noting that these figures have very little statistical confidence. He initially stated multiple times, the unproven claim that COVID19 only spreads via droplets. He promoted the claims that antibodies against COVID will mysteriously disappear. He uncritically discussed the nonsense studies (from sewage) that claimed that COVID19 was circulating in Europe in 2019. He seems to think that we should use the AZ vaccine in Australia despite it's poor efficacy in comparison to the others, rather than wait for Novavax for example.
 
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I saw the thread title and started laughing. Literally.

Given that ME and long COVID have almost the same symptoms, how is one clearly syndromic and the other psychosomatic? Is this not hypocritical?

This is a man who backed the PACE trial, which is somewhere between highly problematic and outright scientific misconduct. It took me five minutes reading the first PACE paper to see issues. How can an "expert" given years of opportunity fail to see the basic problems? Of course it took another four years before we found the smoking gun that shows this is research misconduct, what used to be called scientific fraud. It is not even close to being rigorous scientific research.

Lack of evidence on what long COVID is does not stop people forming an opinion. In rare cases they might even be right. Its just not scientific.

Of course we also lack evidence that ME and long COVID are closely related, but superficially its almost a perfect match up. We have to wait on careful and detailed science. So does he.

We have no way to measure psychosomaticness, to coin a word. So there is no way to establish relative psychosomaticness. We do not even know if psychogenic illness even exists, to get more technical. We do know psychosomatic is potentially valid depending on how it is used though. You break your leg, it changes your thinking. Psychosomatic right there. Psychosomatic is about the relationship between mind (which in my view is just a description of brain function) and body, particularly in disease. Psychogenic on the other hand is about an hypothetical unproven construct they keep asserting is real yet they have no test for it. Psychogenic is about mind causing disease. We have not proven such a cause. We have not even proven the existence of mind as they use it. How is that different from what the brain does?
 
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