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HADD its day: there’s no evidence for an inherited hyperactive agency detection device

Kat Ford
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HADD its day: there’s no evidence for an inherited hyperactive agency detection device

Many of you have probably heard of the hyperactive agency detection device, or ‘HADD’. It’s a great little concept that is incredibly useful to invoke when talking about numerous weird human beliefs. Why do we see faces in clouds? HADD. Why do some people believe in ghosts? HADD. Fairies? HADD. Conspiracy theories? HADD. Aliens? HADD. God? HADD. Got a question about some mysterious goings on that people seem desperate to attribute to the activity of some sentient being or other? HADD it mate. Throw HADD at it, case closed, problem solved! But what is the history of this ubiquitous HADD, and where is the evidence that HADD exists?

The hyperactive agency detection device has its roots in evolutionary psychology, quite a specific approach to evolutionary psychology in fact. Put very simply, the argument goes a little something like this. The human brain is almost like a Swiss army knife. At birth the brain is fully kitted out with pre-existing mechanisms or devices. Given the right environmental input, these mechanisms will spring into action at the appropriate time. These mechanisms have been passed through generation after generation, because individuals in our ancestral environments possessing these traits were more likely to successfully solve challenges of survival and reproduction, and therefore pass on these traits to offspring. Those offspring, endowed with these inherited mechanisms similarly did a cracking job at surviving long enough to create offspring. As long as the same challenge reoccurs, the same inherited solution is useful. Rinse, hump, repeat.

Hyperactive agency detection device is often argued to be one of those nifty little mechanisms that helped ancestral humans navigate a dangerous world. In a world full of lions and tigers and bears (oh my!), better to assume that the rustling sound in the bush is a hungry predator and run like stink, than to ignore it and become something’s lunch. So what if you occasionally leg it because the wind made a noise? Being a bit out of breath is far better than the awful, no good, terrible consequences you might face if you never run from the scary sound.

This logic of the hyperactive agency detection device sits comfortably within the larger framework of error management theory – the idea that some mistakes are far more costly than other mistakes. A classic example used to illustrate the importance of error management is that of the smoke detector. Would you prefer to have a smoke detector that is a touch too sensitive and causes a frantic outbreak of window opening, tea-towel flapping and exasperated swearing every time you dare to make toast, or would you prefer a smoke detector that sits placidly on the wall as your furniture and favourite trinkets get a lovely crispy crust. Clearly, you want the hysterical smoke detector that will take any excuse to sing its ear splitting siren song – better that than sofa flambé. The same is true for human cognition: if a false positive is annoying but a false negative is deadly, it’s best to calibrate your brain in favour of the false positive.

This idea, that humans are hyperactive agency detectors because assuming agents where there are none is less costly than not detecting agents where there are some, is beautiful. It’s elegant and charming in its simplicity and explanatory power. It makes intuitive sense, and it’s just so damn logical! There is just one tiny problem: there is no empirical evidence that the hyperactive agency detection device exists.

In Disbelief by Will Gervais, a few pages are dedicated to this specific problem. Although the concept of a hyperactive agency detection device has been around since the 1990’s, there is no evidence it exists. But this concept is so pervasive, especially among those who work in the cognitive science of religion, that it is almost treated as established fact. During my PhD I tried to investigate a link between heightened sensitivity to agents and religious belief and found… nothing. During their postgraduate days, Will Gervais and fellow researcher Aiyana Willard also tried to investigate the link between HADD and religion but found no evidence that HADD even existed. 

After giving a talk at a conference detailing research that turned up no evidence that HADD was even a thing, Willard was approached by multiple other researchers who similarly spent time conducting research based on the idea that the HADD was the key to understanding religious cognition from an evolutionary perspective only to find the hyperactive agency detection devise was ironically undetectable. I have heard it said that researching a hypothesis generated on the assumption that HADD not only exists but is central to explaining religious cognition, then coming away with null results and the sudden need to change direction as quickly as possible, is tantamount to a right of passage for those of us who have spent time working in the Cognitive Science of Religion. The publication bias against null results is responsible for many doctoral tears.

But if HADD doesn’t exist, why is there so much anecdotal evidence that it does? Why do so many people have the experience of hearing a creak in the night and suddenly becoming filled with the fear that there is a burglar in the house? Why is HADD such an attractive, versatile and intuitively appealing idea?

In the paper agency detection is unnecessary in the explanation of religious belief Willard argues that our tendency to suspect a sentient being (or agent) is present is entirely dependent on context. We do not just assume any unexpected noise in any context or circumstance is an agent, but it depends entirely on previous experience, prior learning, expectations and likelihood. The paper opens by illustrating this beautifully: 

A bump in the night can make us fear that a burglar is in the house […] If that bump is heard deep in the Canadian wilderness ,we are more likely to think – and are better served by thinking – that the sound is a bear. If we are  skiing across snowy mountain peaks, an unexpected noise should make us fear an avalanche rather than any type of agent.

The likelihood that you will perceive a strange noise as a ghost is dependent on whether you live in a culture where ghost beliefs are common. If your culture is full of mischievous pixies, you are likely to attribute unexpected noises to mischievous pixies. The inferences you make will be dependent on the beliefs you already hold. So yes, many of us have had the experience of hearing an unsettling noise and thinking “burglar!” or being in a spooky place, hearing an unexpected whistle of wind and thinking “GHOST!” not because we have a hyperactive agency detection devise, but because of the expectations we have been endowed with due to cultural learning.  

So, why is this story interesting? Two main reasons, I think. Firstly, that HADD is so often invoked, means it is important that we as skeptics are aware of the shaky foundations on which it sits. Secondly, and most importantly to me, it illustrates both the biggest problems and biggest potential in evolutionary psychology and adjacent disciplines. A common criticism of evolutionary psychology is that those who work in the area often tell very nice, plausible stories about the human mind with ideas that seem very logical but are ultimately unfalsifiable. The story of HADD and the research around it is showing something quite different. Yes, the idea has taken hold because it is a nice, pleasingly logical, easy to follow story, but it did allow researchers who are currently still working in the field of human evolutionary behavioural sciences (including evolutionary psychology) to generate falsifiable hypothesis and conduct research investigating this very idea. The idea is probably wrong, HADD probably doesn’t exist, and now researchers are continuing the work of trying to figure out an explanation that better fits and better predicts human behaviour. Yes, even evolutionary psychology can be self-correcting.

Unborn in the USA: being honest about IUDs could help us fight the anti-abortion movement

Colin Brewer
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Unborn in the USA: being honest about IUDs could help us fight the anti-abortion movement

The biggest irony of the repeal of Roe v Wade that has caused the recriminalisation of abortion in some southern states of the USA is that even the most fervent of anti-abortionists have almost entirely ignored a widely used contraceptive method that has aborted far more of the ‘unborn Beethovens and Einsteins’ so prominent in anti-abortion discourse than all the world’s abortion clinics combined. These millions of abortions were caused by one of the ways in which intrauterine contraceptive devices (IUDs) work and, for different but related reasons, both anti-abortionists and family planners seem to have agreed never to mention it. I believe it is worth publicising, however, because it may help to restore the status quo in the USA that prevailed for nearly half a century. It may also help to quash efforts to restrict abortion rights in Europe.

Whatever Constitutionalist arguments were invoked by religious and/or Trump-appointed supreme court members to justify it, the Roe v Wade repeal is a triumph of misogyny which, as well as rape victims, will disproportionately affect the people whose lives are most at risk of being blighted by unwanted pregnancy – teenagers, often from poor families, forced into early and single motherhood or early marriage with all the well-documented problems that generates for them and their children; and mothers already stretched by caring for their existing children. Middle-class women will, as usual, navigate the obstacles more easily, even if they have to go interstate or abroad. Delaying motherhood will increase their education and employment prospects, further increasing their life-chances compared with their poorer counterparts.

If anyone wants to set up a Museum of Irony and Paradox, the main exhibit could focus on abortion, because it attracts so much of the stuff. There’s the capital punishment paradox – the fact that among typical ‘pro-life’ anti-abortionists, with their traditional set of moralities, are many enthusiasts for capital punishment. There’s the historical paradox that we get lectured on the sanctity of life by the spiritual heirs of Catholic and Protestant heretic-burners, to mention only the Christian kind.

There’s also the irony that a large proportion of human pregnancies end in very early spontaneous abortion (the term ‘miscarriage’ usually describes spontaneous abortion later in pregnancy), which suggests that the putative deity of the fundamentalists isn’t interested in maximising foetal survival. Indeed, since many of these early spontaneous abortions seem to involve anatomical or chromosomal abnormalities that would lead to severe birth defects if the pregnancy were to go to term, it also suggests that God is a Foetal Darwinist.

Finally, there’s the peculiarly American irony that the Southern states and white fundamentalists, who have only recently and reluctantly got over their enthusiasm for church-sanctioned slavery and segregation (as Tom Lehrer called it, ‘The land of the boll-weevil/Where the laws are mediaeval’) are among those most keen to ban abortion. This would have the biggest impact on the disproportionately African American poor.

For me, though, the chief irony has always been the way in which anti-abortionists reveal their fundamental dishonesty and hypocrisy over the millions of very tiny ‘unborn babies’ (aka ‘potential Beethovens’) who are, to use their terms, ‘murdered’ every year by the action of contraceptives, especially but not exclusively the intrauterine device (IUD) or ‘coil’. Ever since IUDs were introduced in the 1960s, it was obvious that they worked in a number of ways, including the destruction of tiny Beethovens (they might, of course, be tiny Hitlers or Stalins) during the first few days after fertilisation (and thus ‘personhood’), before or after the implantation of the blastocyst – the embryo’s initial and tiniest manifestation. They are therefore at least part-time abortifacients (ie drugs or devices that cause abortion) and they remain abortifacients even if most of the time, they prevent pregnancies by killing or disabling sperm and/or ova before they can unite.

The fact that the tiny, brainless Beethovens who are aborted at this stage are barely visible to the naked eye does not prevent the Vatican from asserting that they are large enough to accommodate a soul, though that evidence-free assertion dates, along with the doctrine of papal infallibility, only from 1869. Previously, Rome held, equally without evidence, that ‘ensoulment’ took place later, at 40 days for a male foetus and 80 days for a female (and presumably at 60 days for the occasional true ‘hermaphrodite’). Islam gives us a ball-park range of 42-120 days for both sexes: take your pick.

Until the 1830s in Britain, inducing an abortion was not an offence under common law unless it took place after ‘quickening’ – ie obvious foetal movement – around 18-20 weeks’ gestation. Even after seven weeks of development and perhaps two missed periods, our little Beethoven/Hitler is barely 3/4 inch, or 18mm, long. In Oklahoma a few years ago, legislators seized on a more modern version of the Beethoven argument. It was proposed, and very nearly enacted, that women seeking abortion, even after rape, had to watch and listen while a doctor did an ultrasound examination of the foetus and described its cute little fingers. According to The Guardian:

The sponsor of that law, the Republican state senator Todd Lamb, said it was intended to give the mother “as much information as possible about that baby” because it might grow up to win the Nobel prize.

I wrote to Sen. Lamb, making some of the points that I’m about to describe but like many anti-abortion British politicians, he did not respond to my arguments.

Today, there are two types of IUD. The simpler kind is a T-shaped bit of plastic, wrapped around with copper wire. The combination of mechanical and inflammatory action from a foreign body barging around in the uterus and the local toxic effect of copper makes things difficult for sperm and fertilised or unfertilised ova. In the other sort, sometimes called an intrauterine system, the device is impregnated with hormones that may reduce (but are not guaranteed to prevent) ovulation, or implantation.

However, for both types, the product information sheets concede (though usually not very prominently) that causing early abortion is among the modes of action and that people with strong views on these matters may prefer to use other methods. As a 2002 review in a leading obstetric journal concluded,

although prefertilization effects are more prominent for the copper IUD, both prefertilization and postfertilization mechanisms of action contribute significantly to the effectiveness of all types of intrauterine devices.

They also apply to some types of oral contraceptive but I will leave those out of the argument.

Let’s look at what ‘postfertilization mechanisms of action’ means, using the pro-life language of ‘murdered babies’. There are currently over 150 million IUD-users world-wide. Apart from the 100 million of them who live in China and are thus mostly beyond the reach of anti-abortionists inspired by Abrahamic religions (the only ones that seem to bother about it much), that means 50 million women, each of whom might be murdering at least one soul-equipped baby every year, even if hormone-impregnated IUDs mean that they only release three or four ova in that time. That could mean 50 million induced abortions a year, which is far more than the total combined annual live births of Europe and the USA, let alone the much smaller total of notified legal abortions. Even if the true figure for IUDs is only a tenth of that, 5 million is still an awful lot of minced-up micro-Beethovens, though far fewer than are lost in the daily Malthusian wastage and Darwinian weeding-out of defective embryos.

The essence of anti-abortionism is that destroying a tiny embryo is morally the same – or virtually the same – as destroying a full-grown human baby. Anti-abortionists must maintain that stance, or their case collapses. They also have to maintain (and most of them do) that ‘humanity’ begins at fertilisation. That is why the Society for the Protection of Unborn Children campaigned vigorously but ineffectively a few years ago in Britain against increasing the availability of post-coital ‘morning after’ contraception; which works – whichever method is used – by ensuring that if a fertilised ovum results from the coitus in question, it is aborted, either by the prescribed medication or, less often, by inserting a post-coital IUD.

One leading British anti-abortionist obstetrician, Prof. Hugh McLaren did try to argue that ‘humanity’ began at implantation rather than at fertilisation, so that IUDs were acceptable as contraceptives but he encountered two unanswerable objections. The first was that if he could move the goalposts to suit his moral beliefs, so could the pro-choice tendency. The second was that IUDs could clearly work not only after fertilisation but also after implantation. Furthermore, his views were not typical of anti-abortion doctors who are also obstetricians and thus particularly well-informed about foetal development.

A survey of 1760 US obstetricians found that in a response rate of 66% (which is high for this sort of survey),

One-half of US obstetrician-gynecologists (57%) believe pregnancy begins at conception. Fewer (28%) believe it begins at implantation, and 16% are not sure. In multivariable analysis, the consideration that religion is the most important thing in one’s life…and an objection to abortion…were associated independently and inversely with believing that pregnancy begins at implantation.

In other words, the more religious and anti-abortion the obstetricians, the more likely they were to believe that pregnancy, humanity and ‘personhood’ begin at conception and that conception means fertilisation, not implantation. Accordingly, when our own abortion laws were under attack in the decade or so after the 1967 Abortion Act was passed, I wrote to several prominent British antiabortionists along the following lines.

You apparently regard the fertilisation of the ovum as the starting point of humanity.  I do not share this view but it is not an entirely dishonourable one.  However, you may not realise that IUDs work not only by preventing fertilisation but also by destroying the fertilised embryo during the first week or two of its existence, both before and after implantation.  Most of the hundreds of thousands of British IUD-users are sexually active, so they could each be having an early abortion several times every year.  This makes for an awful lot of murders of potential Beethovens (as you regularly portray abortions) and probably amounts to far more ‘murders’ than all the abortions formally notified under the provisions of the Abortion Act. If you really are as outraged by abortion as you claim, you will, of course, want to make it very clear that you are just as outraged by those who manufacture, insert or wear IUDs as you are by those involved in murder/abortion at later stages of pregnancy. I therefore invite you to make an immediate public statement to that effect. Alternatively, if you feel unable to make such a statement, I invite you to explain why you regard the destruction of a mini-Beethoven at one or two weeks as so much less worthy of your indignation than the destruction of the same mini-Beethoven a month, or two or three months, later.

Among the people I wrote to were the former Roman Catholic Archbishop of Westminster (the late Cardinal Basil Hume) and several Members of Parliament, and I still have a collection of wonderfully evasive letters from them. Most tried to change the subject. Leo Abse, one of the MPs and noted for his flamboyant and articulate style, was struck uncharacteristically dumb and declined to continue the correspondence.

I had – and later published – an extensive correspondence with Cardinal Hume, who eventually conceded that if what I said about the mode of action of the IUD was true, which it clearly is, then the point I had made was an important one. He reminded me of his church’s traditional opposition to all forms of contraception but he never subsequently referred in public to the IUD problem. Pope John Paul II (to whom I didn’t write) mentioned IUDs briefly and in passing as part of a general attack on abortion in the early 1980s but rarely referred to the matter thereafter. He never, as far as I know, singled out IUDs, despite their enormous numerical importance in any calculation of murdered Beethovens and blighted souls. I think Americans could have a lot of useful and innocent fun by similarly tormenting the US equivalents and exposing their hypocrisy.

To publicise the issue, I even devised a little stunt in the late 1970s. Together with a medical journalist and an academic expert on abortion law, I arranged for a leading professor of gynaecology to insert an IUD into the uterus of a friend of mine who was a prominent women’s magazine editor. We all then signed a letter testifying that we had witnessed this illegal procedure, namely using an instrument, (specifically an IUD) to procure a miscarriage, contrary to the Offences Against the Person Act of 1861 (where the prohibition of abortion is picturesquely sandwiched between prohibitions of bigamy and buggery) and without the two medical opinions, medical reasons and other bureaucratic requirements of the reformed 1967 abortion law. We then jointly posted this explosive document through the letter box of the Director of Public Prosecutions. Our bit of street theatre got into the papers, but produced absolutely no response. After several months and several reminders, a weary letter from the DPP informed us that he would not take any action against the gynaecologist, despite our request that he should do so. Significantly, he did not argue that the professor had not broken any law.

Short of inviting Cardinal Hume to be one of the witnesses, I couldn’t have done more to alert British anti-abortionists to the medical facts about IUDs but they have remained very reluctant to mention the matter. The reason is obvious. They know that most people – probably including most Catholics – know the difference between an acorn and an oak tree and know that destroying an acorn, or even a small sapling, is not the same as cutting down an oak tree. They know that opposition to contraception is a political dead duck, even in Catholic countries. Finally, they know that most people cannot get very worked up about the moral status of something that is almost invisible to the naked eye but they dare not say that murdering unborn babies doesn’t matter provided that they are only little ones, because that, of course, is exactly the position of the pro-choice lobby. We differ only in our definitions of ‘little’ and all such definitions are largely arbitrary.

Instead, anti-abortionists concentrate on abortions that take place after the foetus has begun to resemble a very tiny (about 1 inch/2.5cm long) humanoid around 10 – 12 weeks after fertilisation, which is the time by which most induced abortions are performed. Anti-abortion films such as ‘The Silent Scream’ argue that abortion is wrong not only because it is murder but also because it is cruel, since it involves dismembering living mini-Beethovens. This is often backed up by heart-warming reports that long before delivery, the foetus can respond to music as well as to pain.

The problem with this highly emotive argument is that pain that isn’t remembered isn’t really pain in the usual sense of the word. If that weren’t the case, we would presumably insist on delivering all babies under general anaesthesia or by Caesarian section, because being squeezed through the birth canal for several hours would be extremely painful. After all, it is such a tight fit that the bones of the foetal skull are often forced to overlap to make the head small enough to pass.

We would also surely insist that male circumcision soon after birth should be done under anaesthesia as well. Babies certainly scream during this procedure (I performed it several times without even local anaesthesia on new-born Australians when it was still fashionable), but they never remember it as adults, any more than they remember being born. Surgical patients under light anaesthesia also react visibly when the knife goes in or when their fractures are manipulated but unless the anaesthetic is far too light, they don’t remember it either. So, ‘Silent Scream’ is misleading.

One might expect that pro-choice exponents and the Family Planning movement would welcome the IUD argument but in practice, they too have kept quiet. Their reasons for silence are very similar to those of the pro-lifers but their motivation is very different. Many anti-abortionists are old-fashioned sexual moralists whose ideological ancestors fought similar battles against contraception and votes for women a few generations ago. As well as those who feel genuinely offended by what they see as the murder of tiny babies with not-so-tiny souls, their ranks include many tedious male supremacists who fear giving women control over their own fertility and sexuality.

Obviously, the family-planning and pro-choice exponents are about as far away from that position as it is possible to be, but they fear that by mentioning the abortifacient effects of IUDs, they may deter some women and some family planning clinics from using a particularly efficient contraceptive method that is also very cost-effective. That is not hypocritical but it is dishonest. They also feared (until President Obama reversed American policy) the displeasure of the US government, which banned all financial aid to family-planning programmes that used, promoted or even discussed abortion. A US government-funded internet contraception library even prevented users from searching for articles containing the word ‘abortion’ until protests caused it to relent. Consequently, one of the strongest and most embarrassing arguments to use against anti-abortionists – that they are a bunch of odious hypocrites – is rarely deployed. I discussed my conclusions with a leading international figure in the world of population control and family planning. ‘You’re quite right, of course’ he said, ‘but you absolutely must not quote me’.

Even in Britain, family planning organisations deliberately conceal the physiological truth. I contacted the Family Planning Association, whose website stated very clearly that IUDs do not cause abortions. They said they could not give me a statement, even though in addition to gynaecologists, they employ many doctors who specialise in family planning and have diplomas to prove it. Instead, they referred me to the Faculty of Family Planning of the Royal College of Obstetricians and Gynaecologists – who could not help me either because I was not a member of the Faculty. In desperation, I sought the advice of Prof. John Studd, an old friend and, until his death in 2022, a very prominent and experienced gynaecologist. He said I could quote him and this is what he emailed me.

After further telephone discussions with “experts”, it seems there has been very little new research on this subject and the thinking is that it is a deliberate neglect in order not to offend the fundamentalists of Rome.

Nothing has changed since I wrote in 1976, for World Medicine:

People working in contraception have told me how there seems to have been almost a tacit international agreement not to discuss the abortifacient properties of the IUD. It is, they say, a useful birth control agent for many countries where an ignorant and unsophisticated peasantry is in thrall to religious leaders who accept contraception but not abortion and who could easily torpedo an IUD programme. I can understand their motives but I do not believe this is an attitude that should commend itself to a reasonably educated democracy.

Brewer C. Mortal Coils. World Medicine. June 2nd 1976, 33-6

I did manage to get a response from one leading British authority on contraception, who happens to be an Evangelical Christian, though he preferred not to be named. He is not an anti-abortionist but he relied on much the same ‘implantation’ argument that the anti-abortionist Prof. McLaren had used, though he also noted the large amount of ‘normal’ foetal wastage between fertilisation and implantation, even without IUDs. How likely was it, he asked rhetorically, that (I paraphrase) an omnipotent, omniscient and omnipresent God with the additional attribute of “omni-common sense”, would expect us to give the status, importance and respect to this unimplanted entity that it acquires, in his view, at the moment of implantation?

Surely it is now safe for the IUD to come out of the closet? The inconvenient truth has been published in scientific journals for over 40 years and even a Republican US government could not easily pretend that it neither knew nor cared about it. I think it would not now dare to withdraw funding from IUD programmes, especially in countries where its advantages make it a preferred method of contraception.

Surely not even Donald Trump really believes that the lot of poor women and their families would be improved by being forced to bear more children than they can support in countries where the process of childbirth is often still lethally dangerous? Properly presented, I think the IUD argument can breach the moral defences of the anti-abortionists (and the anti-stem-cell and anti-embryo research lobbies) more effectively than any other. Their leaders, including Pope John-Paul II, knew perfectly well that millions of IUD-induced early abortions were taking place every year but they mostly preferred not to acknowledge them and said nothing that compared with their regular torrents of outrage about abortions only slightly later in pregnancy. Where does that leave their moral credibility and authority?

Animals, acupuncture and alt-med: the Brazilian penguin being subjected to Enya

Natália Pasternak
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Animals, acupuncture and alt-med: the Brazilian penguin being subjected to Enya

The use of medical treatments based on alternative practices – even under labels like “integrative” and “complementary” – is unfortunately common among humans, as has been covered in this magazine many times. But the notion of using treatments which lack evidence of safety and efficacy on the most defenseless of living beings – animals – is just as important.

People who use – or advocate for the use of – health practices that are without scientific proof (and often based on theoretical foundations that make less sense than flat Earth theories) often defend the practice by arguing that patients should be free to choose what they do to and with their bodies. But what freedom does an animal have? An adult human has the right to choose whether or not to seek treatment as they see fit. Children and animals don’t have this prerogative: they are at the mercy of their caregivers.

Recently, it was reported that a rescued penguin was being treated in Rio de Janeiro for spinal inflammation. The novelty was that the treatment included acupuncture, music, and cannabinoids. But what evidence supports and justifies the use of these practices and substances on penguins or any other animals, whether wild or domestic?

A search in scientific literature reveals that there is basically none. A systematic review published in 2006 examined 31 studies that used acupuncture on domestic animals. Evidence of effectiveness in treating any condition: zero.

Another review, published in 2017, highlighted the low methodological quality of animal acupuncture clinical trials. It also noted that most of the studies were narrative – in essence, the authors told stories instead of analysing data. Of course, if storytelling could prove anything in health, then chloroquine would cure COVID.

Just like acupuncture in humans, veterinary acupuncture is no more than a placebo, as has been shown multiple times. Animals may react to the placebo effect for various reasons – such as conditioning, or the comfort generated by the caring attention from surrounding humans – but there is also something called “proxy placebo”: the animal continues to suffer as before, or even more, while the observing humans falsely believe their situation has improved.

Beyond the issue of scientific evidence, acupuncture in animals doesn’t even make sense according to acupuncture’s own logic, which claims that the human body is traversed by meridians connecting vital energy points. Maps of these meridians are widely available (indeed, they’re so widely available that different schools of acupuncture use wildly different maps). But who mapped the meridians of a penguin’s body? Are there millennia-old schools of Traditional Antarctic Medicine?

Veterinary acupuncture manuals suggest that acupuncture points are simply transposed from humans to animals. This might explain, as pointed out by veterinarian David Ramey, author of a review on acupuncture in horses, why the practice describes a “gallbladder meridian” in equines… even though horses don’t have a gallbladder.

Medications like cannabinoids have never been tested on penguins, so we cannot know the appropriate dosage or side effects. And I’ll leave it to readers to judge who decided that listening to Enya calms penguins… or even humans.

One enthusiast of alternative veterinary therapies referred to the “treatments” imposed on the poor penguin as “more innovative and respectful practices that significantly reduce the need for allopathic medications.” It’s complicated for a practice to be both ancient and innovative. And to whom is this respectful? Perhaps to certain ideological prejudices – like those who use “allopathic” as a pejorative term – but certainly not to the poor, defenceless penguin, who has been prodded with needles and subjected to Orinoco Flow.

Exploding the myth of the longevity “Blue Zones”, where people live beyond the age of 100

Carlos Orsi
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Exploding the myth of the longevity “Blue Zones”, where people live beyond the age of 100

This story was originally written in Portuguese, and published to the website of Revista Questão de Ciência. It appears here with permission.

A sign of the shrinking space for science in the Brazilian press is the lack of attention that this year’s IgNobel Award received – announced on the night of 12 September 2024, there hasn’t been a single prominent mention of it in any of our major newspapers. Which is a shame, because among this year’s winners there is a researcher who exploded a myth that Brazillian journalism had swallowed hook, line, sinker, and dock: the myth of “blue zones” of longevity.

Over a year ago I criticised the concept of “blue zones”: the idea that certain regions of the planet, supposedly inhabited by a disproportionate number of people over 100, could hold the “secret of supercentenarian life.” The idea has even been the theme of a successful documentary released by Netflix.

My criticism was based on the naive interpretation of the apparent correlation between certain habits (such as eating honey, or taking long walks) and supposed longevity. It is the fallacy of survival bias: seeing who has succeeded in some activity and trying to reverse engineer the process that led to their success.

It sounds like pure common sense, but it fails to adopt proper controls: just because two or three billionaires have the habit of waking up at four in the morning, that doesn’t mean that getting up at dawn can make someone get rich – just ask bus drivers or garbage collectors. Such markers of success (or “longevity”) are only reliable if there a significantly increased likelihood of success among the population that adopt them, compared to a significantly lower chance of success among the population who do not. And what if, while there are a few outspoken billionaires who get up before the sun, the rest all sleep until noon, but don’t give interviews about it?

A promotional image in the style of watercolour figures painted onto a map showing primarily China, Indonesia and Australia. Several figures starring in the series "Live to 100, Secrets of the Blue Zones" are depicted as happy and strong.
Promotional imagery from Netflix’s “Live to 100” series, “Secrets of the Blue Zones”.

The recent IgNobel-winning study, published in the bioRxiv repository and authored by the demographer Saul Justin Newman, from University College London, went beyond this philosophical criticism; Newman sought other “common factors” present in the supposed zones of high longevity and discovered a strong prevalence of what he called “anti-health” factors: poverty, misery, high unemployment, high rates of illiteracy, low life expectancy, and high crime.

It is worth noting that, like all material available in bioRxiv, Newman’s study did not go through peer review – but neither, of course, have the many books, reports and documentaries that have credulously promoted the cult of the “blue zones”.

In the United States, the largest “predictor” of the prevalence of supercentenaries (people over 100 years) in a population is the absence of birth certificates in the early 20th century. “In total, 82% of supercentenary records in the US are prior to the adoption of birth certificates in their states. When these states have full coverage of birth certificates, the number of supercentenarians falls 82% per year.”

“I’ve tracked 80% of people over 110 in the world (the other 20% are from countries you can’t significantly analyze). Of these, almost none have a birth certificate. In the US, there are more than 500 of these people; seven have birth certificates,” he said in an interview with The Conversation after receiving IgNobel.

Newman documents several clerical errors going on in places that purportedly contain “blue zones”. In Costa Rica, it was found, by 2008, that 42% of the population registered as over 99 years of age had ‘made mistakes’ when declaring their ages in the 2000 census. In 2010, more than 230,000 centenarians from Japan were found to have been fictional, were the product of bureaucratic errors, or were actually already dead. In 2012, Greece determined that 72% of its centenarians had already died – a likely indication of pension fraud.

According to Newman, the marketing of blue zones – including tourism, the trade of “natural” products from these areas or “inspired” by them, plus books, courses, and television programs – lacks scientific basis, but also the demographic research on extreme longevity is based on highly contaminated data: there are strong indications of fraud, lying or deception by a significant part of those who declare themselves supercentenarians.

He cites a study conducted in the US that showed that centenarians have similar (or worse!) body mass index, physical activity rates, smoking and alcohol consumption levels versus the population that served as a basis of comparison, which was 35 years younger. Newman offers four hypotheses to explain how it would be possible to survive from the age of 65 to 100 by smoking more, drinking more, eating worse, and doing less physical activity each year: 1/ either these behaviors do not cause mortality, or 2/ they cause mortality, but the lives lost are “compensated” in the published statistics by bureaucratic errors in the age records, or 3/ the centenarians are actually more likely to drink and smoke more, or 4/ that older drinkers and smokers lie about their age.

The author gives a hypothetical example to show how a small error or fraud rate in age records can, over time, generate a spurious overpopulation of supercentenarians. Imagine that a 50-year-old man decides to lie, saying he is 60, perhaps to claim some kind of social security benefit. When other people who were actually 60 at the time of the fraud began to die – say, from the age of 85 – our character will still have, in fact, the biological age of 75. If he lives to 95, his official age, recorded in documents, will be 105. Given the small number of supercentenarians, only a few of such situations are enough to distort statistics – and the places where there is more incentive for such fraud are exactly those where the dependence on social security benefits due to poverty is greater, which is the case of most “blue zones”.

“Regions where people most often reach 100-110 years old are the ones where there’s the most pressure to commit pension fraud, and they also have the worst recordkeeping,” explained Newman.

Reading Newman’s article and recalling the Netflix series, it occurred to me that the allure of the “blue zones” derives – among other things – from a romantic fascination with the way of life of “simple people”, from a lyrical view of the supposed purifying merits of poverty, rustic life and rural isolation (views that only held, of course, by those who are not poor, but live in comfort in urban areas). It is a condescending populism converted into the most crass commercialism.

The evidence for pill colour impacting placebo effects gets flimsier the more you examine it

Mike Hall
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The evidence for pill colour impacting placebo effects gets flimsier the more you examine it

In 1996, the British Medical Journal published a systematic review of studies examining whether the colour of a pill could change its effectiveness. At first glance, the idea might make intuitive sense. Red is bold and energetic, blue is calm and serene, so patients might expect different things from red or blue pills and these expectations could influence their reported outcomes.

The review comes to a cautiously positive, if slightly hedged, conclusion: ‘[Colours] seem to influence the effectiveness of a drug.’ Since publication, the idea that different coloured placebo pills can produce different effects has become a frequently cited example whenever ‘the power of placebo’ is discussed in science communication or popular media, with this review often cited in support.

A closer look at the included studies, however, uncovers significant problems. The BMJ references six studies on the impact of drug colour on effectiveness, conducted between 1968 and 1978, all of which are impacted by some methodological or statistical issue.

Blackwell 1972

The first is Blackwell 1972, which was reviewed recently for The Skeptic. Fifty-six medical students were given either blue or pink placebo pills and asked to report which effects they felt. Blackwell claimed to show that blue pills made students feel ‘more drowsy’ and ‘less alert’, compared to pink pills.

Unfortunately this study is small, only single blind, and is based on self-reported effects – a combination which opens the door to all sorts of uncontrolled biases. Worse still, the students were primed with a list of possible effects, making it more likely they would report something even if nothing had changed. There are good reasons to doubt that the findings from this paper represent a real effect.

Schapira 1970

The next paper in the BMJ review is Schapira 1970. Forty-eight patients suffering with anxiety were treated with the anti-anxiety drug oxazepam over the course of several weeks. Although the dose was identical in each case, pills were presented in a range of colours. Patients self-reported their condition and were also evaluated by a clinician. Since the active drug was the same in all cases, Schapira suggests that any differences would be the result of the colour of the pills alone.

While the paper initially reports that anxiety was ‘most improved with green [pills],’ and depression ‘appeared to respond best to yellow,’ (and these are the findings cited by both the BMJ review and Ben Goldacre’s popular science book Bad Science), in fact neither of these findings reaches statistical significance. Schapira reports only one statistically significant finding with respect to pill colour, and that is for the effect of green pills on phobias. Even this finding is questionable, however, since it is based on the clinician reports only (no effect is found when considering the patient reports), and it involved just 17 of the 48 patients. The remaining 31 were not suffering with phobias, since participants were recruited for their anxiety symptoms. The fact that 17 of them also struggled with phobias was unintended and the analysis performed post-hoc.

This effect in phobias also disappears when the figures are properly adjusted to account for the fact that Schapira makes many different comparisons, across pill colour, symptom, and rating type.

Cattaneo 1970

Cattaneo 1970 examined 120 patients awaiting surgery on their varicose veins. The patients were randomly given either an orange or a blue pill and told they were sedatives to help them sleep. In fact, the pills had no drug in them at all. The next morning, patients were asked how long it took them to fall asleep, how long they slept, whether they felt rested, and which of the two pills they preferred.

In an odd leap of logic, Cattaneo asserts that whichever pill patients said they preferred must be the one which best helped them sleep, but it should be immediately obvious why this doesn’t necessarily follow. Perhaps orange is simply their favourite colour? Maybe they’re big Everton supporters and will pick a blue anything regardless of how well it does?

You may also reasonably ask why they are giving fake sleeping pills to patients who are awaiting varicose vein surgery? The paper claims that since they are awaiting surgery, therefore patients must be experiencing mild-to-moderate anxiety. Since they are experiencing mild-to-moderate anxiety, therefore they must have trouble sleeping. And since they cannot sleep, they must need a sedative. 

No effort is made to establish whether the patients actually are suffering with anxiety, nor is any effort made to establish whether they are struggling to sleep; these claims are just nakedly asserted.

An assortment of pills in a bowl, of different shapes, sizes and colours. There are triangular, circular and capsule-shaped pills. Colours include blue, orange, green, white and pink.
Will you pick the blue pill… or the orange pill? Image by Valeria GB from Pixabay

In fairness, the paper does claim that there is correlation between the ‘favourite pill’ and the other self-reported sleep quality scores gathered from the patients, but it makes no effort to quantify this statistically. The primary findings of the paper are then based on this self-reported preference, not the sleep quality scores.

Cattaneo reports that 41% of patients preferred the blue pill and 39% preferred orange. The remainder expressed no preference. Astute readers will doubtlessly have noticed that there is only a very small difference between 39% and 41%. In fact, if patients who expressed no preference are excluded, this is a 51/49 split. This is not a significant effect that can be generalised to the wider population, it is a coin flip.

With no meaningful effect in the overall analysis, the paper then breaks the results down by sex, claiming that men prefer the orange pills and women prefer the blue. This comparison just makes it to the common threshold for a significant finding, with a p-value of 0.042. As discussed in a previous article, the p-value represents the probability of obtaining these results even when there is no true effect. In this case, there is a 4.2% chance we would see these results even if there were no effect from pill colour by sex.

However, we should still be skeptical of the data, which appears to be the product of p-hacking. P-hacking refers to the practice of intentionally or unintentionally manipulating your analysis until you find some significant result and then reporting on that. For example, performing a subgroup analysis by sex when the overall analysis finds nothing. Even if we leave Cattaneo’s bizarre methodology aside, p-hacked data does not lead us to reliable conclusions.

Luchelli 1978

Luchelli 1978 took a similar approach, which is perhaps no surprise given that Luchelli is a co-author on the Cattaneo paper, and Cattaneo is a co-author on Luchelli. This time, 96 patients awaiting unspecified elective surgeries were recruited. The paper reports that all participants had significant sleep problems, including difficulty falling asleep, disturbed sleep, and an average sleep duration of ‘five hours or less.’

Patients were given either an orange-coloured sedative (heptabarbital), a blue-coloured sedative (also heptabarbital, in the same dose), an orange placebo, or a blue placebo. The following morning, they were interviewed to determine how long it took them to fall asleep, how long they slept, the quality of their sleep, and whether they woke feeling rested or groggy.

Unlike the earlier ‘pill preference’ metric, Luchelli used sleep onset and duration data directly in the analysis, which found two significant findings concerning pill colour. Patients who took blue pills fell asleep 32 minutes faster and slept 33 minutes longer on average. No statistically significant effect was observed for pill colour on sleep quality or grogginess.

Despite these results, there are significant issues with relying on self-reported data for metrics like sleep onset time. Be honest, can you recall the exact time you fell asleep last night or how long you slept? Such figures are difficult to report accurately, and there is substantial room for biases to affect these kinds of subjective measurements. Even if pill colour had no real impact, the effect of bias may result in an illusory effect being recorded in the data. Luchelli acknowledges these limitations but defends the approach, claiming ‘sound results have been obtained based on subjective assessments.’

Unfortunately, the paper doesn’t provide enough data to verify whether the statistical analysis was conducted correctly, but the results presented for the effect of blue pills as sedatives are marginal and would likely disappear if properly adjusted to account for the large number of subgroup comparisons made in the study.

Moreover, these subgroup findings contradict the overall analysis. For example, men taking orange capsules fell asleep faster and slept longer on the first night compared to those taking blue capsules, but on the second night, the opposite effect was observed. In women, the effect of blue capsules remained consistent across both nights, but orange capsules were more effective on the second night than the first.

Inconsistencies like these make it clear that, if pill colour has any true effect, it is variable and unpredictable. Given the variability in the data and the small sample size, it wouldn’t be surprising if just one or two outliers were skewing these results.

Nagao 1968

Nagao 1968 is a paper we unfortunately cannot examine in any great detail (despite my best efforts) as I’ve been unable to obtain a copy of the original text. But since it was published in Japanese, I’m unlikely to have understood it anyway. The BMJ does, however, outline the main findings: ‘79% of patients reported adequate pain relief with red pills, compared to 73% with white pills.’ We don’t know if this was a significant finding or not, since we can’t see the data, how the analyses were performed, which other comparisons were made, or the trial methodology.

One observation we can make is that these findings will be based on self-reported data, as there is no real alternative when measuring pain. Self-reported outcomes are especially susceptible to bias, and while it is unlikely that patients are being deliberately deceptive when reporting how much pain they are in, there are several psychological effects which can distort those reports. The subject-expectancy effect can result in patients reporting what they think should be happening, rather than what is actually happening. Social-desirability bias can result in patients reporting what they think is the most pleasing or acceptable answer.

Importantly, these sorts of effects (and dozens of others like them) can modify what is recorded in the data without necessarily changing anything about the patient. For this reason, it can be difficult to disentangle self-reported data from simple bias in studies like Nagao.

Huskisson 1974

Finally, Huskisson 1974 conducted a study on 24 patients with rheumatoid arthritis, each of whom required on-demand pain relief (in addition to their standard care) at least once per day. In a somewhat complicated design, patients were randomised to receive one of three active painkillers or a placebo, with the pills presented in pairs and in various colours, across several days. Patients self-reported their pain relief on a scale from 0 (no relief) to 3 (complete relief), and their responses were recorded hourly for six hours after taking the medication.

Huskisson found that pill colour did not significantly alter the effectiveness of the active painkillers, but patient-reported pain relief did vary by pill colour when administering placebos. No difference between the colours was found one hour after administration, but differences appeared at two hours (p < 0.02), three hours (p < 0.05), four hours (p < 0.02), five hours (p < 0.05), and six hours (p < 0.05).

Despite this, we should still interpret the data cautiously. First, the sample size was small, with at most six patients receiving each coloured placebo. Two patients dropped out of the study, but the paper does not specify why or which groups they left. Second, like Nagao, the results are likely to be influenced by reporting biases, as all the data gathered was self-reported by patients. Finally, even the statistically significant results were relatively marginal, with p-values ranging from < 0.02 to < 0.05. Given the number of statistical comparisons performed, it is likely that even these results would not remain significant if adjusted for the false discovery rate.

Interestingly, the red-coloured pills did not outperform the other colours when active painkillers were administered. This effect, if it represents a real phenomenon, was limited to the placebo pills. However, studies like Huskisson are often used to support the idea that the colour of medication can enhance its placebo effect, even while this study’s findings do not support such claims for active drugs.

Returning to the BMJ review itself, each of the six papers referenced is graded for its methodological quality. Blackwell, which claimed that blue pills made students less alert, scores 6.5/10. Schapira, which claimed yellow pills were better for depression and green are best for anxiety, scores 7/10, as does Cattaneo, with patients waiting for their varicose vein surgery. The remaining three studies, Luchelli, Nagao, and Huskisson, all score less than 5/10.

Taken together, the studies from the BMJ paint a picture not of a meaningful placebo effect tied to pill colour, but of random noise in poorly designed research. Perhaps not a surprise, given that most of it was conducted 20 years before the BMJ review, which itself is rapidly approaching 30 years old. The most impressive effects are found in the studies judged to have the poorest methodological quality, while the better-designed trials show little to no real effect.

This is a pattern we see frequently in pseudoscience: acupuncture, homeopathy, reiki, and similarly implausible therapies tend to show the biggest effects in poorly controlled studies. When proper controls are enforced, the effects disappear.

The BMJ tries to walk a middle ground. The review acknowledges that the evidence is inconsistent while still suggesting that colour might influence the effectiveness of a drug. It ends with a call for more research. And while it’s plausible that colour could change how patients perceive a treatment, the data don’t show a reliable and meaningful clinical effect. The studies that seem to support the idea are small, weak, and flawed. The more robust trials find little of interest.

So should we start colour-coding pills, based on what we think patients will respond to best? I’ve seen more than one commentator make this very suggestion, but absent any robust, reliable, and reproducible data showing that pill colour has a measurable impact on clinical outcomes, I would suggest we focus on what we can be sure actually works: proper treatment, solid evidence, and good science.

Comparing misinformation to a virus is both accurate and useful in preventing its spread

Sander van der Linden
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Comparing misinformation to a virus is both accurate and useful in preventing its spread

A recent UN survey showed that 85% of people around the world are concerned about misinformation. This concern is understandable. Dangerous conspiracy theories about ‘weather manipulation‘ are undermining proper management of hurricane disasters, fake news about immigrants eating pets in Ohio incited violence against the US Haitian community, false rumours about child kidnappings spurred deadly lynchings in India, and misinformation about health (such as ineffective cancer therapies) can have deadly consequences.

In a recent Skeptic article, Modirrousta-Galian, Higham, and Seabrooke recognise the dangers posed by misinformation but also argue that talk of ‘infodemics’ or comparing the spread of misinformation to that of a virus is a simplistic and misleading analogy that offers little but undue alarmism about the problem.

I believe this view is wrong, and predicated on a serious misunderstanding of the scientific literature. Most importantly, although the authors rely on several qualitative critiques of the analogy, they don’t actually engage with the rich mathematical, computational, and epidemiological evidence that illustrates why and how (mis)information spreads like a virus on social networks. This has absolutely nothing to do with alarmism, but rather with a proper understanding of the descriptive and predictive role of formal models in science.

For example, there are many dozens of empirical studies that use standard epidemiological models that are used to study how viruses propagate in a population to study how (mis)information diffuses in social networks. Importantly, these studies all find that such disease models fit social network data very well. This is an empirical fact.

One of the most well-known mathematical models of infectious diseases is the Susceptible-Infectious-Recovered (SIR) model where S stands for the number of susceptible individuals in the population, I for the number of infected individuals, and R for the number of recovered or resistant individuals. These models are typically generated from a series of straightforward differential equations and it’s not difficult to see how these models can be applied to the spread of misinformation where a susceptible individual encounters false information and subsequently propagates it to others in their network.

These models are incredibly useful because they allow us to predict and simulate population dynamics and derive epidemiological parameters such as the basic reproduction (R0) number (the average number of cases generated by an “infected” individual). And indeed, research finds that most social media platforms have an R0 greater than 1, indicating that the platforms have the potential for infodemic-like spread with some platforms having greater potential (eg Gab) than others. Similarly, other work shows how interventions, such as moderation or inoculation, could be usefully integrated in the ‘recovery’ compartment of the model to understand how interventions may reduce the spread of misinformation on social networks. Such models are validated with real-world social media dynamics.

A black and white photo of a senior woman sneezing, holding a paper tissue to her face, while sitting in an arm chair wearing a cosy-looking cardigan
Sometimes it only takes one sneeze nearby to infect you – other times, it might take many. Image via rawpixel.com

Modirrousta-Galian et al describe the analogy as “alarmist” because presumably the notion of infection following a single contact seems simplistic and implies anyone can become “infected”. However, that’s not a nuanced nor accurate view of either misinformation research or infection models. Studies reveal that people barely do better than chance when it comes to correctly identifying deepfakes. Moreover, it is trivial to show that repetition of false claims causes greater belief in those claims – an effect known as ‘illusory truth‘ – which impacts 85% of the typical sample, irrespective of the plausibility of the claim or prior knowledge that the claim is false.

The point is not whether people are gullible or not, but that some fake news stories clearly do spread like a simple contagion (eg fake rumours), infecting users immediately whereas others behave more like a complex contagion requiring repeated exposure from trusted sources (eg vaccine hesitancy). Critically, vaccine misinformation does not even have to convince to cause harm – it simply must induce fear, which we know gets more traction on social media.  

Moreover, the fact that exposure effects can be cumulative, and susceptibility variable, does not detract from the usefulness of the abstraction, because these features are already present in many infection models, ranging from the simple to hugely complex. That all people are not equally susceptible to infection, or that some are virtually immune, or that sometimes you need to be sneezed on multiple times from a close distance to catch an infection, does not make the analogy less applicable. From a modelling perspective, this is a straight-forward matter of adjusting threshold parameters and relationships pertaining to population dynamics, reflecting how easy or hard it is for information pathogens to “infect” subpopulations.

Suggesting a pathogenic analogy for misinformation spread is alarmist misunderstands both the aptness of the analogy and the purpose of modelling. Mathematical modelling can be phenomenological (describing observed patterns) or mechanistic (making predictions based on known relationships) and both forms have demonstrated ample utility in misinformation research. Infodemiology is not just a term invented by the WHO – it’s an entire field of research with many accurate and useful predictions for how false information spreads and how interventions can be introduced to counter its spread. For example, prebunking or “psychological inoculation” interventions preemptively introduce and refute a weakened dose of a falsehood so that people gain immunity to misinformation in the future. Such interventions can be integrated in population models of misinformation spread.

Dismissing well-established analogies for modelling belief dynamics as an alarmist and misleading ‘metaphor’ without discussing the underlying science seems to have serious potential to misinform people on the topic. Misinformation does not occur in a vacuum – for a third of the US population to believe the 2020 election was “stolen”, or 37% to believe the FDA are suppressing a cure for cancer, requires beliefs so conceptually specific that they must evidently spread person-to-person, to our collective detriment. That not everyone is as readily susceptible does not negate this fact. Of course, although there’s a lot of mileage in the analogy, it’s not perfect. In the words of George Box, “all models are wrong but some are useful”.

If we really want to effectively tackle the spread of misinformation, we need all hands-on deck, including viral models that are both accurate and useful, not only for gauging where we stand, but to illuminate how we might counter the harms of misinformation in the future.

2000 mules: why many Americans are convinced Trump won the 2020 election

Jim Cliff
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2000 mules: why many Americans are convinced Trump won the 2020 election

In the recent vice-presidential debate in the United States, JD Vance refused to answer a simple question. Did Donald Trump lose the 2020 election?

It’s not surprising that he didn’t want to admit it. While vice-presidential debates are rarely consequential, he couldn’t afford to lose support from either his notoriously thin-skinned running mate, or the Republican base, and as recently as August 2024 an ABC/Ipsos poll found that only 30% of Republicans believe that Joe Biden legitimately won in 2020.

Why does this belief persist, despite a total lack of evidence of widespread voter fraud? Part of the reason is Trump himself, who tells his supporters at nearly all his rallies that the only way he can lose in 2024 is if Democrats cheat “again”, like they did in 2020. But, when pressed, a significant portion of the Republican faithful will tell you that there is, in fact, evidence that Biden stole the election – all you need to do is watch 2000 Mules.

2000 Mules promotional film poster featuring a man dressed in black with his hood up and face covered, pushing ballots into a box.
Promotional poster for the ‘documentary’ 2000 Mules, written and directed by Dinesh D’Souza. ‘They thought we’d never find out. They were wrong’, reads the tagline.

Directed by conservative pundit and conspiracy theorist Dinesh D’Souza, 2000 Mules is a documentary that purports to show exactly how the election was rigged, through a network of left-wing non-profit organisations who “harvested” ballots and used paid operatives, or “mules”, to distribute them around multiple ballot drop boxes in battleground states.

The theory was dreamed up by Catherine Englebrecht and Gregg Phillips of True the Vote, a right-wing group dedicated to uncovering “irregularities”, which in their view threaten the integrity of elections. While you might not know their names, you may be aware of their previous work – Trump’s 2016 claim that he “won the popular vote if you deduct the millions of people who voted illegally” came directly from Gregg’s assertion that he had found evidence of three million “non-citizen votes”. Despite promising to release proof of this to the public, he never did. Similar unsubstantiated assertions form the backbone of 2000 Mules, but they are lent the veneer of legitimacy by the sciencey-sounding way True the Vote collected data to prove their case.

Gregg explains in the film that your phone is constantly emitting and receiving signals that include geolocation data, and apps gather that data. Sometimes that’s so that the apps can help you navigate, or help an Uber driver locate you, and other times apps will collect it so that they can show you ads relevant to your location, like if you’re close to a McDonalds, for example. The other reason they collect this data is that they can then sell it to data brokers.

True the Vote bought 10 trillion of these location data “pings” so that they could pinpoint where people had been during the election period.

In the US, mail-in ballots can be returned through regular mailboxes or by posting them in secure ballot drop boxes. True the Vote chose to focus their investigation on the five states that Trump won in 2016, and Biden won in 2020, and in each state they located each of the drop boxes and cross-checked their phone data to see who had visited those locations on multiple occasions.

Gregg and Catherine reasoned that a voter would visit a drop box when posting their own ballot, and perhaps they might find themselves near a drop box another time, but anyone who has more than a few visits starts to look suspect. They decided to set a threshold of 10 unique drop box visits and five visits to some unnamed non-profit organisations, which True the Vote theorised (for reasons never explained in the film) were being used as “stash houses” for harvested ballots; any individual who met that threshold is, by their definition, a “mule”. They use these terms because, they claim, this operation resembled drug trafficking or human trafficking, but in this case it’s ballots that are being trafficked. Using this method, they claim to have identified a little over 2,000 mules in the five states they studied.

In case the geolocation evidence doesn’t convince you that these people were up to no good, True the Vote also used Open Records requests to gather official government surveillance video of drop boxes, so that we can see the mules at work, and around 24 are shown in the film. Based on the phone data they have gathered, assuming each mule deposited an average of five ballots on each visit to a drop box, and further assuming that each of those ballots was voting for Biden, then Trump in fact won three of those five states, and enough electoral college votes to win the 2020 election.

Unfortunately for Dinesh, True the Vote, and Trump, it’s a bit more complicated than that.

Not Quite

First of all, there’s no reason to make those last two assumptions. Even if we accept everything else in the film, we can’t know who the votes were for. As for the average number of ballots, based on the 17 clips they’ve included in the film where you can at least kind of see what’s going on, the average is 2.8. The most we saw from anybody was six.

More importantly, they never show us any of their geolocation data, which makes it very hard to check. However, we can check the accuracy of phone data to see if it would even be possible to use this method to prove their claims. According to the US government “GPS-enabled smartphones are typically accurate to within a 4.9 metre (16 foot) radius under open sky”. However, that little phrase “under open sky” is crucial. To get the best accuracy, the phone needs to have line of sight to four satellites, so it’s worse near buildings, bridges and trees.

One study from the University of Georgia found that in an urban environment the average error for a smartphone using GPS was about 10 metres and in some cases was as high as 40 metres. It’s clear that proving someone was within 5-40 metres of a drop box isn’t the same as proving that they actually posted some ballots in the box.

But what about that video evidence, surely that must prove something?

Well, no. The only video footage they have is from Georgia, where it’s completely legal to deliver ballots on behalf of family members or people in your care or custody, so showing someone posting several ballots at once isn’t proof of anything. And, despite claiming several times that they have evidence of people going to multiple drop boxes, they don’t show any video of the same person at more than one drop box, or even the same drop box on multiple occasions.

In fact, one of the featured videos, of a man posting five ballots, was investigated by the Georgia State Election Board just days before 2000 Mules was released in cinemas in the US. Investigators identified the man, checked public records, and found there were five legal electors living in his home, all family members, and using the state’s voter verification system determined that ballots for all five of the voters were dropped at the drop box in question on the date the video was taken.

  • Screenshots from 2000 Mules, falsely claiming to show election fraud in progress
  • Screenshots from 2000 Mules, falsely claiming to show election fraud in progress
  • Screenshots from 2000 Mules, falsely claiming to show election fraud in progress
  • Screenshots from 2000 Mules, falsely claiming to show election fraud in progress

Unfortunately, this was the footage Dinesh chose to play while he says, in voiceover, “What you are seeing is a crime. These are fraudulent votes.” At the end of May 2024, the film’s producers, The Salem Media Group, paid the man a significant settlement, made a public apology, and removed the film from their platforms.

But the film is still available because, while Salem backed down, Dinesh and True the Vote refused to settle and are continuing to fight the lawsuit. You can still stream it on Dinesh’s locals channel and on Rumble, and election deniers still point to it as definitive proof of fraud because they refuse to check a single claim it makes in case their beliefs are shaken.

If Trump loses to Kamala Harris in November, I’ve no doubt these same claims will be repeated, and Trump and some of his most fervent followers will remain convinced that this film holds the key to why he lost.

2000 Mules and One Big Lie: A Stubborn Conspiracy Theory, by Jim Cliff is available now in print or ebook format.

Wim Hof: the self-described ‘Ice man’ whose extreme health claims leave many cold

Michael Marshall
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Wim Hof: the self-described ‘Ice man’ whose extreme health claims leave many cold

If you pay an attention to the world of alternative health, or the many, many podcasts and video series in which men (and it’s always men) talk about self-optimisation, you’ve almost certainly heard of Wim Hof. Hof has spent decades extolling the virtues of hyperventilation regimes and cold water plunges, claiming all manner of health benefits and protective qualities. He has made a career of illustrating the power of “The Wim Hof Method” via a variety of endurance demonstrations, building himself a lucrative brand as motivational speaker and quasi-spiritual guru along the way.

Wim Hof was a wellness expert on the Goop Lab, Netflix’s Gwyneth Paltrow collab. He was the star of Vice documentary Inside the Superhuman World of the Iceman. He fronted the BBC series Freeze the Fear with Wim Hof. He’s appeared on shows with Ellen DeGeneres, Joe Rogan, Russell Brand, Jordan Peterson, Stephen Bartlett, Brian Rose, and almost every other wellness channel and hustle culture program around, feted as an expert in what the human body can do, because of the record-breaking things his body has done.

Wim Hof speaks to Paltrow and Goop’s Chief Content Officer, Elise Loehnen, on Netflix’s Goop Lab. Via IMDB

It is undeniable that Hof has been capable of record-breaking feats of cold-temperature endurance. In 1999 he broke the Guinness World Record for farthest swum under ice, managing 50m without a diving suit, breathing apparatus or flippers, in his second attempt. His first, the previous day, ended abruptly after he tried without goggles, only for his corneas to freeze, temporarily blinding him. A year later, he went for the record again, extending it to 57.50m.

Hof’s record breaking wasn’t done, nor was his habit of seeing which bits of his body would freeze in interesting ways. In 2007, he ran a half marathon, on ice… barefoot. Hof completed the run in 2 hours 16 minutes, and his Wikipedia page lists it as the only current Guinness record in Hof’s name… though, as we’ll come to, that does not appear to be true.

In 2015, Hof took a team of 18 inexperienced climbers to the top of Kilimanjaro in just over 31 hours, without even first acclimatising them to the height. Hof said they could avoid altitude sickness by training in the Wim Hof Method, which is a combination of breathing techniques, ice cold water plungers, and meditation, which he believes is the key to his feats of endurance.

A photographer snaps pictures of Wim Hof, wearing a white headband, sat in a tank of ice that reaches up to his chin.
Wim Hof sitting in an ice bath. Image via aad on Flickr, CC BY-SA 2.0

Finally, Hof broke the record for the longest time in direct, full-body contact with ice, spending 44 minutes in a box of ice cubes in January 2010. The he broke it again. And again. And 13 more times. Which is undoubtedly impressive. But is it really evidence that the Wim Hof Method is good for your health? To answer that, we must first understand what his method actually entails.

The Wim Hof Method

Hof’s eponymous method consists of taking regular freezing-cold ice baths, plus a breathing phase where you take 30-40 deep breaths in very quick and forceful succession, inducing hyperventilation, at which point you hold your breath for a while, and then take a deep breath and hold it. This has to be repeated three to four times. Doing this regularly, according to Hof, can have the kind of health benefits and protective qualities that allows him to pull off record-breaking feats of cold water exposure.  

Applications of the Wim Hof Method aren’t just limited to endurance feats. In interviews, Hof has claimed that it can cure headaches, which he says are caused by a lack of oxygen in the brain. He has also claimed that cold plunging and controlled breathing could be the answer for billions of people who suffer from high stress, anxiety, low motivation, inflammation, cardiovascular issues and other treatable conditions.

He told a journalist at the Guardian that his method will help treat osteoarthritis, and also depression. The Times reported that it can help with Parkinson’s, and according to Hof, will help you “live longer, never get ill or depressed”. In a 2014 interview in his native Netherlands, he intimated that he believed it could help cure cancer, saying:

I believe that every disease is an immune system that has gotten out of balance…
I absolutely think that, 95% of all diseases, including many forms of cancer, can be cured.

Unsurprisingly, the Wim Hof Method has been studied scientifically. In one study, Hof was injected with a harmless form of E. coli, which should cause flu-like symptoms, but he didn’t develop them, staying asymptomatic. So researchers took 30 participants, trained 18 of them in Hof’s breathing methods, and injected them with the same E. coli, noting that those 18 also escaped the worst of symptoms, compared to the other 12. But given that this was an incredibly small study with a wholly inadequate control arm, we can’t actually draw any conclusions from it.

However, even if this were a robust study, the findings might not be a surprise, because we already knew hyperventilation reduces the body’s inflammatory response via the release of adrenaline… but that isn’t always a good thing. The body has an inflammatory response for a reason, and you’re not always going to be in lab conditions getting injected with E. coli that’s designed to be harmless. And even if it were useful, the effect lasts while you’re currently hyperventilating – once your breathing returns to normal, your body goes back to normal. That’s what bodies do.

Unfortunately, it is not the only thing that bodies do when they hyperventilate – hyperventilation can also cause dizziness, and even passing out. Given that the Wim Hof method often involves people hyperventilating in or around ice water plunges, there’s a serious risk that proponents pass out in or into ice water. As of January 2024, journalist Scott Carney (who spent some time with Hof, and accompanied him up Kilimanjaro) had identified 21 reports of people dying while practicing the Wim Hof Method, mostly people passing out and drowning in various bodies of water of varying temperatures – and the total may even be higher. In June 2024, an exposé in the Sunday Times collated coroner’s reports from several of these deaths, citing a lawsuit in which the father of one victim argued that Hof and his company had been negligent.

Wim Hof and endurance

While the Sunday Times has much to say of the potential risks of the Wim Hof Method, they do not cover Hof’s claims as to his own remarkable feats of endurance. However, while interview after interview explains the many records Hof has broken, few interviews actually bother to follow up on those records to see where they currently stand.

Take, for example, Hof’s record of swimming 57.50m under frozen water. Hof no longer holds that record – the current holder is Czech free diver David Vencl, who in 2021 managed 80.99m… without the aid of an eponymous breathing ‘method’. Similarly, Hof’s barefoot ice half marathon record of 2 hours 16 minutes has been smashed by Josef Salek, Jonas Felde Sevaldrud, and most recently Karim El Hayani – the latter completed the feat in just 1 hour 36 minutes in 2021… without self-identifying as a super human.

Furthermore, while Hof held the record at 44 minutes spent in full-body contact with ice in January 2010, the current record is held by Lukasz Szpunar, who managed a colossal 4 hours 2 minutes, hours beyond Hof’s best attempt. But there are no Netflix or BBC documentaries about Szpunar and his mystical ability to endure the cold.

As for taking a group of inexperienced climbers up Kilimanjaro, the devil is in the details. The team didn’t reach the top – they went as high as Gilman’s Point, significantly short of the summit. And six participants had to turn around before making it to the top, because they got altitude sickness – around a third of the group. On top of those were the climbers who, while not reported to suffer from altitude sickness, were so exhausted by the climb they had to be brought back down by car… including Wim Hof himself.

This is important, because part of the usual climbing duration for Kilimanjaro involves giving yourself time and space for a safe descent – if you’re not factoring in being well enough to come back down the mountain safely, you can obviously move much faster. You can also undertake parts of the climb at riskier times, when it would usually be too dark to do it safely. If anything, then, Hof’s 31-hour climb was slow – in 2014, the record for climbing Kilimanjaro was set by Ecuadorian climber Karl Egloff at just 6 hours 42 minutes. Egloff actually went all the way to the top of the mountain – but you haven’t heard of him, and hustle-culture podcasts aren’t telling wide-eyed tales of his otherworldly ability to climb mountains.

It is not the only mountaineering claim of Hof’s that warrants scrutiny. In 2007, according to his legend, he climbed Mount Everest wearing just shorts and sandals. By which he means, he undertook the start of the journey bare chested while his team accompanied him with all of the regular mountaineering gear, which he would put on when not actively moving.

This is obviously more impressive than any attempt I’ve made at the mountain, but, crucially, the risk on the lower and middle slopes of the mountain isn’t actually exposure to the cold – in good weather, you can reach as high as 6,400m and it can still be around 20°C. The highest temperature ever recorded at that altitude on the mountain is a sweltering 37°C.

In fact, given the temperatures, dehydration is more of a risk during that stretch, because climbers are usually carrying the equipment they’ll need for higher up the mountain, when it starts to get seriously cold (unless, like Hof, they have a team to do that for them). The website EverTrek explains that, in April and May, it is “not uncommon to see climbers wearing t-shirts all the way up to Camp 3”, an elevation of 7,200m. Hof’s climb took place in May.

When Hof and his support team got to 6,700m, he decided to switch to mountaineering boots, to allow him to use crampons for the trickier sections. He then abandoned the attempt at 7,400m – 200m past Camp 3 – due to what he called a recurring foot injury… which, as he told The Times in an interview, was actually frostbite:

“So I had a deep mental conversation with my foot and it reported frostbite. I appreciated it was the right thing to turn back,” he said. “Extreme cold is a teacher. The lessons come to you through the body. You just listen.”

Again, I have never even attempted to climb Everest, so to have achieved even that distance is impressive… but when Hof tells the tale, he describes it as climbing Mount Everest in a pair of shorts, and the people who buy into his guru-like mystique picture him reaching the summit in his underwear.

What we should recognise here is that while Hof’s feats of endurance are impressive, they’ve also been spun into a legendary reputation that’s afforded him a guru-like mystical quality, and one that he’s gone all-out to cultivate and preserve… even as his actual records have been comprehensively smashed by people who don’t present themselves as mystical, and don’t get invited onto podcasts to explain how we can all hyperventilate ourselves free of illness.

If Hof’s records being comprehensively beaten by people who boast no mystical spiritual fortitude were not problematic enough for his legacy, there’s a final nail that might hold that coffin fast. Wim has eight siblings, one of which is his brother, Andre. His twin brother, Andre. His identical twin brother, Andre.

Andre, from what we know, has a very different lifestyle to Wim, and doesn’t do punishing endurance training, extreme exercises, or cold water plunges. But despite all of that, his tolerance for cold temperatures is comparable to Wim’s. As best as we can tell, Wim and Andre are genetically better suited to enduring extreme colds than the average person, regardless of how much time they spend in cold water plungers and hyperventilation.

If Wim Hof’s – and indeed, Andre Hof’s – ability to endure cold temperatures comes from a genetic advantage, then it cannot be taught. Equally, if Hof’s remarkable feats of record-breaking endurance can be matched, and substantially bettered, by athletes who don’t employ hyperventilation regimes and cold water exposures, then any benefits of the Wim Hof Method are called into question – a troubling conclusion, if the Sunday Times is right about how many deaths and injuries have befallen those trying to emulate achievements that were at least partly due quirks of Hof’s genes.

Wim Hof is no stranger to giving interviews, in fact he may be one of the most-interviewed wellness gurus on the planet over the past 5 or 10 years. It is therefore a shame that, in all of those many conversations, his interviewers have chosen to fawn over his self-concocted legend, rather than asking the kinds of questions that would-be followers of the Wim Hof Method clearly need to hear.

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