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The Virus and the Placebo

The placebo effect will have to be taken into account in the development of vaccines and treatments, according to this opinion in Stat News.

“The placebo response is a complex psychobiological phenomenon that describes the clinical improvement seen in patients taking dummy or sham medicines. It can also comprise some proportion of the measured effect among patients receiving active drugs. Multiple behavioral, psychophysiological, and neuroimaging studies have shown that the placebo response is a real, multifactorial effect associated with changes in biochemical pathways in the brain. The effect is patient specific and is influenced by patient expectations and certain well-defined personality traits.

While drug developers are attuned to considering the placebo response in areas like pain and depression, it may not be immediately apparent why it is so critical for the development of Covid-19 therapies and vaccines. What set the stage was the FDA’s regulatory guidance, released in May, directing how the biopharma industry should evaluate drugs and vaccines being developed to fight the pandemic.”

What’s in a placebo?

When is a placebo not a placebo? It seems that placebos are no as ‘unreactive’ as the literature would suggest. Research hastened and made more urgent by the rushed efforts to develop a Covid-19 vaccine have revealed the need to create a standard for the actual content/ingredients of the placebo used in a given trial.

This article claims that:

“Some researchers conducting clinical trials on a COVID-19 vaccine have not revealed to the public what the placebo contains, but they should. This is because the placebo ingredients influence how effective or harmful the active treatment, with which the placebo is compared, appears.”

Later, the article continues:

“Placebo controls are rightly the gold standard against which new treatments are measured. If a new treatment proves to be better than a placebo, it is taken to be effective. Otherwise, it isn’t. The problem is that until today, there has been no standard for placebos, which made estimates of side-effects confusing. Our new guideline fixes this problem by encouraging rigorous reporting of placebo ingredients.

We’ve known about the failure – and need – to report what’s in placebos for 15 years. By following the new guideline, we can get more accurate information about how beneficial and harmful treatments tested in placebo-controlled trials are.”

Here’s a study on ‘A guide and checklist for reporting placebo and sham controls’

Using placebos in a Covid 19 vaccine?

In this article the author argues strongly against using the ‘double blind placebo controlled’ methodology in testing the effectiveness of the numerous vaccines now in the works.

” … the use of a placebo in a challenge trial for a Covid-19 vaccine is both pointless and ethically questionable.

We’ll use a deliberately simplistic analogy to help explain why. Suppose we need to test a new type of parachute during wartime, when a better parachute happens to be urgently needed. Sooner or later it will have to be tried in a real jump. But we won’t let that happen until we are already quite sure it is going to work. And we are certainly not going to give dummy parachutes to a control group, randomly selected from a group of volunteers. We already know what will happen to them.”

While this logic may hold, as far as testing vaccines go, but we wonder if there’s space to think that, at least for symptoms if not the condition itself, placebos might have a place? After all, nobody yet understands how an intangible input like a placebo actually seems to cause real effects in the material world …

‘Non deceptive’ placebo treatments

We have posted for a while now on so-called ‘open label’ placebos, and the placebo effect engaged when someone actually knows they’re taking a sugar pill (or any other placebo treatment such as a saline injection).

This report, in Science Alert, claims that “across two experiments (…) during a highly arousing negative picture viewing task, non-deceptive placebos reduce both a self-report and neural measure of emotional distress.”

It seems that ‘open label’ placebos can also be described as ‘non-deceptive placebos’. This designation is of importance where researchers try to tackle the ethical issues involved in ‘lying’ to people about the test drug (or non-drug) being administered.

The report is based on research published in the prestigious journal Nature, Placebos without deception reduce self-report and neural measures of emotional distress .

“What if someone took a side-effect free sugar pill twice a day after going through a short convincing video on the power of placebos and experienced reduced stress as a result?” says lead researcher and psychologist Darwin Guevarra from Michigan State University (MSU).

“These results raise that possibility.”

The ‘Pancebo’ Effect

“The pancebo effect is when a person begins to worry that the worst is about to happen without valid evidence. It’s panic over logic.”

This article at Huffpost was written by a Canadian in the early days of the virus (where were you on the 2nd of March?). Of course it reads as naive and uninformed right now, in August, but we include it because it’s the first time we’ve come across the term ‘pancebo’, which remains topical. This was not, perhaps, the author’s intent, since he was referring to a kind of fear-panic (a ‘nocebo’) inspired by the emergence of Covid-19. Instead, these days, it might better refer to the rash of crazy conspiracy theories that crowd our newsfeeds. It’s still about fear, but the ‘pancebo effect’ of fear of the virus seems to have been translated into a generalised fear of authority figures, health officials, government and anyone who can be vaguely associated with the panglobal lizard people who are ‘really’ in control.

Big Pharma: Organised Crime …?

This article isn’t pulling any punches: Big Pharma and Organized Crime — They Are More Similar Than You May Think

“If you believe pharmaceutical corporations hold the health of the general public in high regard, it’s time to reconsider. The industry is filled with examples of wrongful death, extortion, fraud, corruption, obstruction of justice, embezzlement, fake journals, harassment and hit lists that would make even the most hardened Mafia godfather blush.”

Cheesy Placebo Jokes

Scientists have come up with a new name for experiments that utilize placebos

Trick or treatment

+++++

I’m addicted to placebos.

I could quit but it wouldn’t matter.

+++++

On my way home from work today I was listening to Placebo..

I thought I was listening to something else, but obviously I was the control group.

+++++

Is that placebo working for you?

Well, now that you mention it, no.

+++++

My doctor is concerned my hypochondria is getting worse

So he put me on stronger placebos.

+++++

I got in trouble for using performance enhancing drugs

I took a placebo before my psychology exam

+++++

I was part of a scientific study on the calming effects of listening to the Three Tenors.

I felt great, but was in the control group. It turns out I was listening to Placebo Domingo.