[epistasis]

The subversion of scientific expertise to replace it with podcasters and political sycophants is one of the biggest disasters of the current years.

The very concept of merit has been destroyed and replaced with judgement calls on celebrity (necessary for leadership role) and subservience to the political whims of the last 15 minutes (and you had better switch in the next 15 minutes or you're out).

[SecretDreams]

Really reminds me of the Russia leadership portrayals in Chernobyl.

[SlightlyLeftPad]

That’s exactly what it is.

[nfw2]

One thing that's particularly frustrating about all this is that any conversation with the growing contingency of distrustful people has been made very difficult by what I would call poor, avoidable, and illiberal decisions made by the federal government during COVID. (TBF, decisions during a crisis are always hard.)

Lab leak theory was dismissed and actively suppressed. Inflated claims were made a priori about absolute vaccine efficacy that any responsible researcher who have not made.

Moreover, the trouble with trying to shut down real disinformation, eg claims that vaccines were more dangerous than the virus, is that many people will view any sort of paternalistic behavior by the government, especially around speech, with suspicion. ("Why do they care so much about what I say? They must be hiding something")

In the age of social media, I think the study of public health needs to consider more seriously the effects of viral psychology. The irrationality and stubbornness of people needs to be expected when planning public policy.

[datsci_est_2015]

Having lived through it myself, I found the government’s actions extremely mild when compared to something like what ICE has been up to. Zero people were directly killed by authorities because of Covid noncompliance.

From my perspective, it’s hysteria borne out of the difference in requirements for urban health policy vs. rural health policy, and the fact that rural people quite often travel through urban areas (e.g. airports).

Talk to anyone from Wyoming and ask what Covid was like during the worst days, and then talk to an ER doctor who worked in New York City.

Cynically, I want to blame it on the absurd lack of empathy of rural Americans and a complete lack of ability to imagine day-to-day lifestyles that do not match their own.

Were there a few scandals? For sure, I will not deny that. But I have the distinct urge to invent time travel for the hemmers, hawers, and devil’s advocates and transport them to New York Presbyterian in April of 2020.

Edit: I also have to credit rightwing media, of course, for capitalizing on the opportunity to manufacture a wedge issue that every American had an armchair opinion of. Chicken and egg, of course, but media ghouls will be media ghouls.

[SpicyLemonZest]

There are many people who say they view any sort of paternalistic behavior with suspicion. But one obvious example of paternalistic behavior would be banning vaccines that people want to receive based on vague concerns of unproven harm. An even better example might be creating a site called realfood.gov, instructing the American people that only some kinds of food are "real" and you should ideally only eat "real" food.

So if someone says they oppose paternalism in public health and yet supports the Trump administration's public health efforts, I'm not sure how to avoid the conclusion that they're lying.

[mmooss]

> The subversion of scientific expertise to replace it with podcasters and political sycophants

> The very concept of merit has been destroyed ...

It's the subversion of truth. I think that way of saying it is more accurate, addresses the consequences, and is less occluded by jargon: People care about truth; 'scientific expertise' may seem esoteric to most people.

I think HN is frequently part of that process: Merit - expertise, actual trials and evidence - is replaced both by sensational too-clever hot takes / takedowns, and by political/social advocacy.

Most threads begin with a takedown, a 2 minute drive-by from an amatuer, often of years of research by someone spending their life studying the matter. For some issues, we all know what side many will take before you know any facts or evidence.

These comments are normalized and given greater credibility than the OP and than valuable comments. How is that any different than the things we criticize (other than the FDA's subversion of truth [EDIT:] is far more consequential [sorry, I didn't finish that sentence!])

There are valuable comments to be found; maybe that's one difference, but I'm wonder how the signal-to-noise compares with other forums.

[epistasis]

How is discussion on HN different from the leadership levels at FDA?

Very different. Decisions with enormous health implications, enormous financial implications, are made at FDA.

At HN, most people are here to learn, here to understand more.

Vinay Prasad is a fraud, completely unfit for the leadership role he was placed into, making baffling and arbitrary decisions on his own, overturning those with far more experience, knowledge and expertise.

If a HN comment gets things wrong, a few people might be misinformed, if they are credulous enough to not double check things.

When the FDA makes decisions like they have been making, thousands to millions of peoples' lives are worse off, and billions in capital is wasted.

Discussion forums of all sorts are incredibly valuable, even when they get things wrong. I have lots of complaints about the overhyping of, say, CRISPR, especially on HN, but whatever, it's a far far higher signal-to-noise than a random person I meet around town. Mention you work on drug development for big pharma to the random person and they think you're evil, at least HN is less likely to have that basic misconception.

[JumpCrisscross]

> Vinay Prasad is a fraud

What’s with him being allowed to continue to practice at the University of California [1]?

[1] https://vinayakkprasad.com/

[epistasis]

That is a good question, and I'm sure many of the people at UCSF are asking similar questions. However, his sort of misconduct is not the type that would usually violate tenure protections. Beyond the minor CV fibbing, without some evidence that he actually, say, solicited a bribe from Moderna, it's unlikely that he can face any sort of official sanction.

The fraud is in his supposed thrust towards better scientific rigor when he is so sloppy with major decisions of life and death.

Just as the comment up there says that HN comments that are critical and misinformed get a lot of attention and upvotes, Prasad has been highly critical and misinformed about scientific research, and his stint at the FDA has exposed that his critiques are much like that top-level HN comment that doesn't get things quite right.

[JumpCrisscross]

> not the type that would usually violate tenure

How can one tell whether he has tenure?

[epistasis]

For normal research universities, like UCSF, the titles of Professor and Associate Professors have tenure. Assistant Professors are tenure-track, meaning that they have the chance to get tenure. Prasad has the title of Professor.

[peyton]

> he is so sloppy with major decisions of life and death

To be clear, the FDA regulates marketing claims. “Is the label accurate?”

Major decisions about life and death are between the doctor and the patient, not the FDA.

It sounds like you’re taking an expansive view of this government agency’s mandate. People will push back on this at the ballot box, even if they can’t put it to words themselves.

[estearum]

The FDA regulates which drugs make it to market which is itself an extremely powerful force (excessively so) on conversations between you and your doctor.

In the case of vaccines, FDA's decisions can quite obviously make a difference in whether we have a rampant lethal pathogen roaring through our schools and killing our children and elderly... or not.

It's pedantic to the point of being outright false to say the FDA is not involved in major decisions of life and death. Silly take.

[8note]

> Mention you work on drug development for big pharma to the random person and they think you're evil

this is how Martin Shkreli described his work of identifying drug patents to buy that he could jack up the prices on. If that's the extent of the description you gave, I think random people would be right to first think you are doing something evil

[Zhenya]

I’m curious why you claim he’s a fraud, I just learned about him from this thread.

[epistasis]

Prasad, to the extent he had a reputation before, was for critiquing the scientific practice as inadequate, which would hope that he'd bring the idea of rigor to his stint at the FDA. Instead, we see quite the opposite:

- This baffling Moderna decision, which is so bad that many in the industry assumed it was from a failed bribe solicitation

- Linked in this article is the "truly evil" decision requiring sham brain surgery in the placebo arm for a Huntington Disease trial https://arstechnica.com/health/2026/06/truly-evil-fda-reject...

- Prasad holding a defamatory PR event about the company producing the HD candidate treatment, and only talking "on background" to hide his identity, which is sleazy and unethical "The criticism apparently struck a nerve with Prasad. The FDA held a press briefing later Thursday in which an unnamed “senior FDA official”—who identified himself as a hematology-oncologist—launched into a diatribe against UniQure, saying its “failed therapy” was supported by “distorted and manipulated” data. As for Woodcock’s comments, the official said he “expect[s] better” from her." https://arstechnica.com/health/2026/03/trumps-divisive-fda-v...

- His first ouster and reinstatement last year, over a unilateral Duchenne muscular dystrophy decision, severely lacking in scientific rigor and analysis

- Lied on his CV about being on a highly prestigious council he was not on (The Cancer Letter is not a random YouTube channel, it's high quality cancer research journalism) https://www.youtube.com/watch?v=pCASAb7J-LE&t=41

As is often the case with such contrarians and critics, their own critiques apply most aptly to themselves.

[dogmatism]

Nah, by 2021 Prasad's reputation had gone into the shitter

I actually think he's just grifting and the notoriety he achieved went to his head. His pre-2020 takes were better reasoned and at least worth engaging with. I could see his takes shifting with popular misinformation ideas in real time as it contributed to his success

IMO this is worse than if he were just wrong. I think he knows better, but then he talked himself into a box, and doesn't have the people and political skills to survive on a bigger stage.

[JumpCrisscross]

> Lied on his CV about being on a highly prestigious council

You called this “minor CV fibbing” above. If he was lying about this when he applied for tenure, wouldn’t that be Cause?

[DANmode]

People making decisions at the FDA should also be actively learning and understanding more all the time.

That should be their primary objective.

[mmooss]

> Decisions with enormous health implications, enormous financial implications, are made at FDA.

Yes, I started writing that and didn't finish the sentence (see my edit near the end of the GP).

But I don't let HN off the hook: The attitude I described in the GP represents and perpetrates the same outlook that politically supports or tolerates this behavior from the FDA. HN users generally legitimize that approach rather than discrediting it.

> Mention you work on drug development for big pharma to the random person and they think you're evil

I think that's paranoid: The random person won't know what that means. Few who know will also know or care about the social implications. Of those who do, only some will be knee-jerk critical of big pharma, and fewer still of research rather than the business side. It's also a victim perspective: Big Pharma has enormous power; punching up at power by questioning, criticizing, and being skeptical (or even cynical) is not at all the same thing as punching down at the vulnerable. If someone wants the power and resources and salary of Big Pharma, benefitting from its enormous power, the pushback and reputation impact comes with it (though the latter is usually positive - great resume material and credibility).

[naturalmovement]

Imagine being able to shut down discussion at the FDA because a few anonymous randos pushed a "flag" button when they saw something they disagreed with.

[dlev_pika]

Apparently, the ‘fuck your feelings’ crowd DOES care about some ‘feelings’

[bediger4000]

At HN, most people are here to learn, here to understand more.

There's a substantial "learn and understand" cohort, but there are other factions. At the start of the pandemic, there were 2 posters explicitly here to proselytize Trump style conservatism. I'm reasonably certain there was an anti-vaxx voting ring 2020-22, and I suspect there's remnant Elon fanboy and MAGA coordinated voting.

I'd love to be proved wrong on these things.

[rho138]

So you don’t agree with their point and saw fit to draw out a response that fingerpoints at the the side that’s over the intolerance of the non-scientifically bound members of society? Great high horse fam.

[MaxHoppersGhost]

“Scientific expertise” was already sold out to politics as we saw during covid. The further degradation to podcast bros is the cherry on top.

[dgacmu]

Both VRBPAC and CDC's ACIP did remarkably good work during the pandemic under enormous pressure - what specific complaints do you have? They got safe and effective vaccines out there fast, did a really reasonable job of balancing the cost benefit w.r.t. side effects of both j&j's and the somewhat elevated myo/pericarditis risk from moderna's vaccine in young men, etc.

Be specific?

(I have complaints - I thought Dr. Meissner was wrongheaded about opposing allowing EUA to extend to pediatric populations. But the committee as a whole functioned well and balanced the urgency of the situation with the need for voluminous data.)