The End of X?

I recently read on a Dutch news site that a public television and radio broadcasting organization (KRO-NCRV) had decided to leave X—the social media network formerly known as Twitter—because of recent examples where X failed to prevent or moderate racist messages targeted at a Dutch rap artist. Then, not long thereafter, a high-ranking Dutch government official also announced her departure from X. For similar reasons.

I can scarcely proclaim myself surprised, having already left that vitriolic social media platform sometime mid 2023 for precisely the same reasons; the surge in misinformation, racism, and discrimination ever since Musk took over. And that surge is not just imagined, but has also been objectively verified by researchers (who Musk subsequently sued, see Figure 1). But is leaving X the best approach to dealing with the objectionable content on X?

Figure 1: Musk’s idea of “Free Speech”

For example, the Dutch social media expert Scheufler (mentioned in the first news item I link to above) thinks leaving X is a cowardly decision, and points out that racism does not go away by simply leaving a platform. But that argument I would counter with the observation that social media platforms derive a large part of their value from the high profile individuals and companies that have a presence there.  When those users leave, that exerts pressure for X to change. When companies leave, then that starves X of much needed advertisement revenue, for example. Racism will not go away… but at least normal users will not be confronted by it and Musk does not get paid to host it.

At the same time, of course, the freedom to express independent thought should not be stifled by overzealous censorship. But let me point out that censorship was absolutely never an issue at Twitter—before it became X—as can readily be concluded from the fact that Twitter was already blocked in a number of not-free countries long before Musk took over. Twitter users have always been given plenty of leeway. Too much leeway actually, even back when Twitter employed an army of moderators. But it was still better than today, and I doubt anyone was surprised that things got a lot worse when Musk got rid of what little basic moderation there was. Except of course when it comes to his own experience on X, then there is plenty of moderation. For example, when he was so irked by an X user reporting all the flights of Musk’s private jet (which is public flight data, by the way) he had him banned from X (that user subsequently moved his account to Mastodon and is merrily continuing the work there). Musk may say that all X users are equal… but clearly some are more equal than others. And make no mistake; Musk may frequently organize polls on some of the decisions, but X is still just his own personal website. That new CEO he appointed changes nothing, as that is just an employee he can just as easily fire again… they don’t work for X, they work for Musk, regardless of whatever legal construct his lawyers may or may not have erected to obfuscate that fact.

Figure 2: Slightly joking Venn diagram of “Free Speech” on X under Musk’s ownership.

Musk’s version of ‘free speech’ appears to be that if someone says something you disagree with, then you just sue them (see Figure 2). A multi-billionaire using frivolous litigation as a bullying tactic. Because when money is water—he’s already the richest man in the world right now and on top of that he basically awarded himself a $56bln bonus1, which is even more than the $54bln financial support package recently approved for Ukraine by the European Union—it doesn’t matter whether Musk wins or loses: the person he targets still has to defend himself in court, with all the financial risks that entails for an individual or non-profit with limited funds. So even if Musk loses the case, he still wins the battle. And how ironic is it that while Musk sets his lawyer team on a hunt like a pack of wolves—to shut someone up for saying something he disagrees with—he simultaneously boasts about all the wonderful freedom of speech on X and happily facilitates the promotion by quacks on X of all kinds of medical misinformation. One famous example is the promotion by these armchair ‘doctors’ of hydroxychloroquine (HCQ) as a treatment for COVID-19, when this drug has never been proven to work against COVID-19 and recent research even suggests a roughly 11% greater fatality rate in hospitalized COVID-19 patients who where treated with HCQ. Thus, his refusal to moderate the medical misinformation posted on his website is potentially resulting in X users getting injured or even killed. Where is the justice in that? Who is going to sue Musk? And why would anyone reward a malignant policy like that by continuing to use X and thereby generate income for Musk? 

I honestly hope the end of X is near, for everyone’s sake, and leaving X will certainly achieve that if enough companies, famous people, and government officials turn their backs to X, so that regular users also begin to follow suit. The first signs of that happening may already be beginning to show.

  1. In fairness, the $56bln bonus for Musk was recently voided by a Judge, but that ruling will no doubt be appealed against so he may actually still receive it. ↩︎

Why I quit Twitter

About a year before the corona pandemic, I suddenly developed a very rare progressively paralyzing auto immune disorder that destroyed the myelin in my peripheral nervous system to the point that I was rendered tetraplegic, and my breathing was also affected to the point that I came close to requiring ventilation. It took doctors about two months to finally figure out what was going on, and progression was finally halted (just in time) with high dose steroid treatment. A slow, painful process of uncertain recovery then began in a clinical rehabilitation centre. Fortunately, I managed to recover enough to awkwardly hobble out of there, limping on crutches. It then took me at least another three years for further recovery, with two relapses along the way. But I was lucky: most in my situation do not recover to this extent, and I was told by the neurologist in charge of the medical specialists treating me that I would likely never recover fully. Indeed, I was told over 90% of the people in my situation remain disabled to some extent. But thankfully I beat the odds. I guess I was just lucky… in a way (of course, truly lucky people don’t get sick like this to begin with.)

Then the SARS-CoV-2 pandemic happened. Not so great timing, as the treatment for my disease (prednisone and rituximab) left met quite immunocompromised and more vulnerable to covid-19 than most. Twitter then became a very useful resource for information on covid vaccine development, new treatments, and just any kind of scientific knowledge on this new infectious disease. There was a veritable explosion of scientific papers. Many good papers, but also many bad papers. Even with my background in biology, it became very helpful to get feedback from leaders in relevant scientific fields to be able to sieve the torrent of publications. Known experts in virology and other relevant medical fields started taking to Twitter to communicate with each other, discuss current literature, and to inform the public about the developments. I started following many of their Twitter accounts. At much the same time, however, a few ‘scientists’—along with many people with absolutely no background in science at all—also started posting misinformation on Twitter.

It then became painfully apparent that the world was woefully unprepared for a crisis like covid. We never really understood just how little the general population knew of science, but this pandemic sure was a wakeup call. The vaccine side-effect monitoring system VAERS, for example, was suddenly widely misinterpreted and misused by anti-vaccine activists. Vaccines and evidence based medicine in general were eschewed, while all kinds of quacks started prescribing unproven vitamin treatments and medicines. Even the then president of the United States of America (Donald Trump) during a press conference bizarrely suggested scientists should investigate injecting bleach into the human body as a potential treatment. It was utterly insane, there was sometimes just no limit to the stupidity. Governments called upon social media to take self-regulation action and help protect public health by limiting the spread of blatant medical misinformation from quacks and covid conspiracy theorists. Finally, rules were implemented by Twitter et al. that forbade, or at least pretended to limit, the spread of medical misinformation surrounding covid-19.

Twitter remained messy, even with the anti-misinformation measures. It usually took great effort and lots of users repeatedly reporting accounts to get Twitter safety to take action. With considerable effort, however, a few notorious covid-misinformation spreading accounts were ‘permanently’ banned from Twitter. Then Elon Musk took over Twitter in October 2022, and all that changed. Since then, many of those banned quacks and grifters have had their accounts restored on Twitter, basically turning the platform into a totally worthless cesspool. The unchallenged publication and widely shared anti-vaccine pseudo-documentary “died suddenly” represented a particularly historic low-point.

Even before Musk, Twitter was often a bit of an open sewer. But it seemed, at least, that there was some kind of equilibrium, that there was still some balance. But post-Musk Twitter has now effectively become the internet’s primary echo-chamber for extreme right-wingers, racists, anti-semites, homo-/trans-phobes, anti-vaccine covid-deniers, and conspiracy theorists. For example, I have recently reported a user on twitter who posted a WWII picture of an apparently obese Jewish prisoner in a Nazi camp along with messages suggesting that the photo proves Nazis didn’t starve Jews, or posted trans-flags arranged in a swastika pattern. Such utterly perverted mixtures of anti-semitism, ironically combined with calling human-rights activists Nazis, have increased noticeably. Twitter ‘safety’ (ahem…) ruled that no violation was detected in both cases I reported. I wasn’t surprised. Since Musk dismantled the moderation system of Twitter by firing most of the employees, virtually no measures remain in place to stem the tide of hate speech, or the deliberate, financially motivated ‘dezinformatsiya’, or plain, ignorant, misinformation. More recently, anti-vaccine conspiracy theorists have even gone so far as to resort to stalking and harassing medical scientists and posting the video evidence of their criminal behavior on Twitter, as recently happened to professor Peter Hotez. That was the tipping point for me.

When you can barely tell the difference anymore between Twitter and right-wing platforms like Truth Social or Gab, you know Twitter is done. That, combined with Twitters apparent open support of people spreading just the kind of harmful misinformation that affects people with my medical history, was the final straw. I downloaded a backup for archiving and then deleted my account. Time to move on.

On the stupidity of comparing COVID-19 healthcare burden to lifestyle diseases

Here in the Netherlands, as elsewhere, hospitals are again seeing a huge surge in admissions of COVID-19 patients. But this time, as in many other countries, the overwhelming majority of these patients are unvaccinated. The disproportional burden on ICU capacity caused by these unvaccinated COVID-19 patients means that non-urgent care is now postponed in most hospitals.

Those opposing the COVID-19 vaccines (also known as ‘anti-vaxxers’) are rightly blamed for this situation. But the anti-vaxxers themselves disagree with that point of view. One of the more popular responses from anti-vaxxers is the argument that the choice not to get vaccinated is no different than any other life-style choice, like smoking, not exercising enough, eating too much, engaging in sports with high risk of injury, or drinking alcohol. The ardent anti-vaxxer will often claim that these risky behaviours are on equal foot with refusing the vaccine, and go on to remind us that smokers also take up ICU beds. Here I will illustrate why that argument is completely fallacious.

Let’s start with smoking. Smoking tobacco is an immensely complex addiction problem, involving strong physical and psychological dependence. And smoking related illnesses do not manifest immediately. It typically takes many decades before smoking cigarettes leads to disease. We should therefore remember that people who may occupy an ICU bed today because of smoking tobacco, often started this extremely addictive habit at a time when smoking was still allowed in public places and was widely considered socially acceptable behaviour. Furthermore, while a long-term smoker who quits today will certainly experience an enormous health-benefit by doing so, there will nonetheless always remain some permanent damage from the many years of smoking. Medical conditions from past smoking may thus still arise years later, requiring some degree of ICU level care. But this is in no way comparable to ending up in the ICU during a pandemic, when everyone floods the ICUs at more or less the same time by refusing a proven safe and highly effective vaccine. This just doesn’t happen with smoking: they don’t all just get lung cancer in the same year. And when (ex-)smokers do end up in an ICU, they don’t stay there for two to three weeks or longer. Refusing a safe medicine is not the same—at all— as a huge societal problem as tobacco abuse, or any other drug problem for that matter. In many cases, substance abuse is related to genetic factors, socioeconomic factors, and in some cases is considered by specialists to be a form of self-medication for certain mental illnesses. Oftentimes there is not so much ‘choice’ at all regarding this lifestyle. And refusing a vaccine, usually based on misinformation and by simply ignoring common sense, is nothing like that.

Other comparisons anti-vaxxers frequently make involves obesity and alcohol abuse. But just like smoking, these are intractably complex issues that cannot be readily solved in the short term. Extreme cases of morbid obesity are even treated with surgery, for Christ’s sake! How is that in any way comparable to refusing a vaccine? It’s insane! There are nations who have declared obesity a pandemic, and have literally imposed special taxes on certain foods (e.g. sugar-tax in the UK) in an attempt to stem the tide. Again, this has nothing to do with refusing a safe vaccine; an addiction or genetic predisposition to not getting vaccinated is unknown to science. A genetic component to the pigheaded stupidity of the anti-vaxxer also remains to be elucidated.

The final comparison I have seen is that in which the choice not to get vaccinated is likened to the choice to engage in high-risk sports. And for some reason I often hear skiing used as an example. Well, alright, let’s do the math. First we’ll look at COVID-19. In the case of unvaccinated people, let’s say the average risk of ending up in the ICU because of COVID-19 is about 5% and the chance of dying is about 1•6%. Could be more and could be less, depending on the country you look at. That’s 50,000 ICU patients and 16,000 deaths for every one million people. So how does skiing compare? Well, in the US the chance of dying from a skiing accident is just shy of one-in-a-million; for every million people visiting a ski-resort, statistically speaking one of them will die during their visit. ONE IN A MILLION! Skiing is over three orders of magnitude safer than getting COVID-19! An NSAA report from 2011 tells me less than 50 skiing related deaths were reported over a period of ten years in the US (at least from in the >90% of US ski-resorts represented by the NSAA). While every death is one too many, 50 deaths in 10 years is about 0.007% of the US COCID-19 deaths in a little over a year. Thus, comparing skiing to COVID-19 is statistically—in terms of fatality risk— just about the same as comparing a trip to the beach in a Volvo to a goddamn NASA rocket mission to outer space! That is literally how ridiculous the comparison is. So let me learn you something that is generally true: ANY sport or activity that is as dangerous as getting COVID-19 would be declared ILLEGAL immediately, without question. Normal people wouldn’t even be able to get insured for such an incredibly dangerous activity, unless you paid an ASTRONOMICALLY high insurance fee.

So to summarise: COVID-19 is not to be compared to health risks associated with ANY life-style. That has to stop right now. Not getting vaccinated is quite simply both insensible and irresponsible, and unnecessarily burdens public healthcare. Yes, in Western countries we have a lot of freedom. However, while you may very well exercise your freedom to refuse the vaccine, that choice does not liberate you from responsibility and consequence. And believe you me that choices always have consequences. In the absolute worst case scenario, if ICUs get completely overrun, you could very well find yourself being triaged right out of the ICU to receive just standard hospital care, with perhaps in the end some palliative sedation to ease your passing while your wailing loved ones can’t even give you a last kiss. This is a nightmare scenario no doctor ever wants to see, but the unvaccinated seem to be doing everything in their power to make it happen. If you are one of them, then please reconsider. Get the vaccine. It’s safe, it’s extremely well tested, and it really works. It’s never too late to change your mind.