On Substack, medicine, and journalism

The last time I tried to cooperate with a magazine writer who had questions for me — with Derek Thompson of the Atlantic in 2021, it didn’t go so well.1

So when Hannah Docter-Loeb of Nature emailed to ask if I’d talk for an article “about Substack and people who use Substack for health/science information,” I was inclined to say no. But her questions seemed to be in okay faith, so I decided to answer.

To steal the old line about second marriages, it’s the triumph of hope over experience.

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(Hope lives on! For pennies a day.)

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But I do have a bit of protection. Below are her questions and my answers in full. So when the piece comes out, we’ll all be able to judge if she represented me honestly. Besides, I think the conversation is interesting, and I hope you agree.

Without further ado…

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1. How/when/why did you start on Substack?

I started in May 2021. I feared that Twitter was losing its footing as a free speech sanctuary and I wanted a backup as the pressure on me for mu views on the mRNAs intensified. I was less concerned about the ability to charge readers, since I did not know how many would pay. I really began to write in earnest in June, with this piece [I included a link to the June 15, 2021 article about the death of Simone Scott].

2. If you had to pitch your Substack in a sentence or two, how would you describe it?

A contrarian but not conspiratorial take on problems in healthcare and medicine (with a particular focus on pharmaceuticals) – and whatever else I want to write about it.

As I put it to readers: Matt Taibbi is our leading countercultural writer on politics; I think Unreported Truths can be the same for healthcare and Big Pharma (and maybe already is).

3. How does it compare to writing for “traditional media” i.e. the NYT or just other platforms?

It allows a much freer voice and allows me to roam much more. I can write about whatever I like and have a direct connection with my readers. I can also get pieces out quickly and write on my own schedule. And I make more money than I would (or did) at the Times.

4. What are the benefits of a platform like Substack?

See above.

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(The Pandemic’s Wrongest Headline. If only the Atlantic were in on the joke.)

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5. What are the drawbacks?

Because I work alone, I am conscious that if I’m not writing, readers aren’t getting anything. Occasionally I have shied away from writing longer reported investigative pieces because I know they would take a long time and I am not sure my readers would care enough about them to justify the pause in articles. This goes doubly for a book I am thinking about writing; if I go forward with it, I will really have to make sure readers understand what I’m doing, and possibly give them some excerpts.

Also, I could probably use a copy editor, I seem to make small copy-editing mistakes in many stories, no matter how closely I check.

6. You mention that Nature has a “see-no-evil” attitude about mRNAS: what are your concerns about mRNA vaccines? What about vaccines generally?

This answer could be a book.

I think in general the mRNAs were not adequately tested and have largely failed; they delayed Covid infections for a few months in most recipients, but they failed to produce anything like the lifelong or near-lifelong immunity we typically expect from vaccines. There is no – I repeat NO – clinical trial evidence that they reduce deaths from Covid, because the companies did not conduct the clinical trials in a way that would have produced that evidence, though they could have; they simply would have had to test the shots against an older, sicker population (as we did with the Covid monoclonal antibodies).

Their side effect profile is clearly far worse than we initially expected, or what we see with inactivated virus vaccines. They produce unexpected long-term system changes after the first booster dose (the IgG4 class switch). They have directly caused thousands of deaths at a minimum – I am very comfortable with “thousands,” and I can point you to the studies from South Korea, Qatar, and elsewhere that explain why.

I could go on, but I think that will do for now.

I don’t think Nature has grappled with any of this.

As for other vaccines, as I have said more than once, my children were vaccinated with the standard (non-Covid, non-flu, non-RSV) vaccines, and I’m comfortable with that choice. I’m still considering whether they should get the HPV vaccine.

In general, though, I think both sides have become overly fanatical about vaccines – it is very clear that deaths from vaccine-preventable illnesses were trending sharply down in Western countries long before most vaccines were introduced. It is also clear that there is little if any evidence that vaccines cause autism; it is not even clear if autism rates are really rising, or if we have simply reclassified practically all severe mental illness as autism – and if rates are rising, factors such as increasing parental age may play a role.2

[But overall] I think public health has become far too focused on vaccines and dismissive of parental concerns about them; the effort to push and even mandate Covid jabs for kids, who are at VERY low risk from Covid, made this monomania clear and has caused a huge and understandable backlash.

7. Some scientists I have spoken to have criticized Substack because of what they see as unregulated propagation of “anti vaccination” and “pseudoscience” views. I’m curious your comment/response to that.

Twitter in 2020 and now X and Substack today are breaking down credentialism and destroying the ability of scientists at elite institutions to control debate.

I am still stunned that the crucial early work on the lab-leak theory was done on Twitter by a bunch of anonymous and semi-anonymous users, while the mainstream virology community simply refused to investigate and even tried to stop independent inquiries — for the obvious reason that it feared the blowback that would follow if people understood the likelihood that gain-of-function research ahd caused the epidemic.

The “unregulated propagation” of speech is a basic human right, and I trust that people can sort out credible sources and rumor- and fearmongers for themselves.

Yes, there’s plenty on Substack I don’t like. But I’m glad it exists. I am not in favor of restricting or regulating speech (except in VERY limited circumstances, such as child pornography or criminal conspiracy or outright fraud that has a financial component).

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(Free speech against the legacy media. With your help. And don’t forget to send your address for the T-shirt if you sign up as a founding member…)

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8. Your Substack is listed under “health politics.” Why did you choose to characterize it that way, or is it just how the search functions?

I don’t know why it’s there.

9. Is there anything else you think is important to add?

I am proud of my work on Substack – I think it meets the same standard that I and my editors applied when I worked at the Times, if not higher, because I know I am on a tightrope with no editorial overview and fully accountable for everything I write.

I think it’s absurd that other journalists tried to censor me and encouraged Twitter and then Substack in 2020 and 2021 because I wrote articles they didn’t like. I think it’s doubly absurd that my successful lawsuit leading to my Twitter reinstatement and my new lawsuit against the Biden administration and Pfizer for their conspiracy in forcing Twitter to censor me have not received national media coverage.

If, say, a Boeing executive had worked with the Trump administration to coerce Twitter to suspend a journalist for investigating dangers in a new Boeing passenger jet, every news organization in the country would rightly regard what had happened as a scandal. That’s an exact analogy to my situation, but because my lawsuit is related to my reporting on the mRNAs, the media won’t cover it.

All best

Alex